Author: Tetiana Palamar

Larisa has been using drugs for more than ten years and is HIV-positive. Having children, the woman has learned to use the drugs in a controlled manner and treats her health consciously.

At the beginning of May, Larisa and her son set off to one of the local lyceums to submit an entrance application form to the first form for the new study year. The woman had chosen precisely this educational institution because of its proximity to their home, and everything seemed to be going the right way. The secretary of the lyceum had already started checking and filing the documents as the future class teacher of Larisa`s son entered the office. The teacher appeared to be an old acquaintance of the woman, so she knew about her risky lifestyle. In the child’s presence, she started offending the client and informed her that “drug-addict” families would not be in her class as such people have no place in her “elite class”. Larisa decided not to continue the conflict rolling out in her child`s presence, leaving the educational institution upset.

The next day, the woman decided to turn to the REAct project. After hearing that, the documentator immediately intervened and promised to help. Larisa received psychological assistance and a consultation about the legal issues and offered to talk with the director of the lyceum about the situation that had arisen. Besides, the client received help compiling an official form regarding refusing to provide educational service.

Later, during the conversation with the documentator, the director of the lyceum apologized to Larisa and helped her to choose another class teacher for her child. Regarding the official response that the client received, the teacher who had refused the child`s education was reprimanded and given a disciplinary conversation.

Hanna asked the REActor for help on the phone. The woman reported that a client beat her. The man stole her money and ran away. Considering that they were outside the city, Hanna couldn’t call a taxi, so she decided to call an ambulance. Yet the ambulance operator refused to send the car as he did not see the necessity to do that. Moreover, he recommended Hanna in the future “to think with her head and not get drunk, because with such a profession she can even lose her life.”

Hanna realized that in such a condition, with a face beaten and in blood, in the dark time of the day and without money, she had no chance of stopping a passing by car. Being desperate, she decided to turn to a REAct documentator.

The documentator, Olena, and the coordinator, Yulia, personally collected Hanna from the place of the event and delivered her to the nearest ambulance station, where they stayed with Hanna all the time and supported her. The client was given first aid: her wounds were treated, and the stitches were put on the open wound on the head. Hanna refused to report to the police. She was later taken home and made sure to be safe.

In two days, the client met with an amicable psychologist who provided Hanna with a psychological consultation on living through the violence and fighting post-traumatic stress. The psychologist helped identify the problem and voice the feelings. After the session, Hanna was also offered some more free meetings to stabilize her emotional state.

Natalia is a pensioner who has a disability of the 2nd group. The woman has faced difficulties in the ambulatory stage in the local clinic during the tuberculosis treatment. In June, she was refused to receive the next portion of the anti-tuberculosis drugs, arguing that Natalia hadn`t undergone the intermediate diagnostics in the regional anti-tuberculosis dispensary located outside the city.

Unfortunately, the client did not have the financial means to do that, and because of her health condition, she could not realize this trip. Considering that the break in the treatment could have negatively affected the results of the fight against tuberculosis, the woman applied to the REAct project documentator. REAtor immediately contacted the medical worker who had refused Natalia and explained that the specialized transport that ran according to the schedule was possible to send the patient’s biomaterial to the dispensary laboratory.

Later, the documentator organized the sending of the necessary biomaterial, which made it possible to conduct the examination that supported the provision of anti-tuberculosis treatment. Thanks to the intervention of the documentator, Natalia’s treatment was resumed, and the woman was given all the necessary anti-tuberculosis drugs. With the help of REAct, the client received new hope for recovery and successfully overcoming this severe disease.

Viktoriia contacted the REActor for help because her child was being bullied in daycare. The little girl had repeatedly complained at home that other kids were constantly saying bad things about her mother, the teacher called her names in front of everyone, made her pick up and put away the toys other children had been playing with, and yelled at her. Viktoriia suspected being a target of mean-spirited comments and verbal abuse behind her back so she asked the kid’s grandmother to pick her up after daycare. But the last straw was when the kid complained to the daycare teacher that another girl was calling her names and hitting her, but the woman replied that it was all her own fault and blamed it all on her poor upbringing.

The little girl came home all in tears and flat-out refused to go to daycare again. The next day, Viktoriia visited the daycare center in person and discussed the situation with the teacher. The latter brushed all accusations aside and advised the client to adjust her behavior and take better care of her child because otherwise, the girl would grow up to be just like her mother. “Everyone knows perfectly well what kind of lifestyle you lead,” the teacher said as they were wrapping up the conversation.

The client was outraged and replied that her private life had nothing to do with anything and that she was a good mother and spent enough time with her kid. Some personal remarks were exchanged, and then the head of the daycare center joined in the argument to privately advise the woman to find another daycare for her kid given the negative attitudes shown by the parents of the other kids. Realizing that the situation was hopeless, Viktoriia got in touch with the REActor for assistance and guidance.

The REActor, Olena, and the project coordinator, Yulia, escorted the client to the psychologist’s office. The latter talked her through the necessary steps to take and gave her recommendations on how to behave in stressful situations and how to provide support and distract the child from negativity, as well as how to show love and empathy. Apart from this, a joint session with the child was suggested to properly explain the reasons behind the negative attitudes towards her and improve the situation for the future.

In addition, the project’s legal counsel gave Viktoriia an initial consultation over the telephone. The lady specialist explained what to do if her child is bullied, what parents are supposed to do if that happens, and where to seek help if necessary. Viktoriia received assurances of support and assistance in case she should encounter any legal issues. However, the client refused to file a complaint with authorities and chose to transfer her kid to another daycare center with a more child-friendly environment, but she agreed to receive further psychological counseling.

Andriy contacted the REActor asking for support in getting medical care, as his pleas were denied by the military commissariat (Armed Forces Recruiting Office). The man reported being detained on the street by draft office personnel and taken to the commissariat, where the client tried to explain that he was severely ill and unfit for combat duty for health reasons (as he had stage 4 AIDS disease). The commissariat representatives replied that they had their physical evaluation board to carry out medical fitness assessments and that they would evaluate Andriy’s fitness for military service, even though he was willing and ready to provide relevant medical records and reports.

When Andriy showed up to undergo a medical, the doctors on the physical evaluation board would not even listen to the man’s health complaints and declared him perfectly healthy and fit for service.

Once all the facts were in hand, the REActor immediately headed to the relevant Territorial Recruitment and Social Support Center located in Odesa. In a conversation with the second-in-command officer, the REActor explained that Andriy was severely ill and had all the supporting documentation readily available. In addition, the man takes his ART regularly, is unable to function in daily life without medication, and his condition requires ongoing medical supervision and monitoring by an infectious disease specialist, which can also be confirmed and supported by appropriate documentary evidence.

The military recruiting office agreed to wait until the REActor and the client’s sister provided the necessary paperwork. The REActor called Andriy’s attending physician, who flat-out refused to provide the family with any Medical Certification of Illness, even though the client consented to this arrangement.

After lengthy discussions with the military recruiting office, the latter finally agreed to take the client to the regional AIDS center for a medical examination, which confirmed that Andriy was indeed suffering from AIDS and TB, and needed treatment. After that, the client was released, removed from the military conscription register, and recognized as unfit for military service for health reasons.

To birth her baby in safety, a pregnant PLHIV client moved from a war-stricken area where she was residing to a relatively peaceful city and obtained an IDP status certificate for herself. Once her baby was born, Inna found herself in a desperate situation and thought she would also try to get her baby recognized as an IDP. When she applied for this to the Social Welfare Office located in the area of temporary resettlement, she was denied this service because allegedly she was already a recipient of social assistance as a single mother.

When Inna questioned the case worker’s decision and mentioned her friend from another city who had the same status but was awarded a targeted child benefit, the welfare worker she was talking with framed her response rudely saying, “I’m the law here, and I decide who gets the support here and who does not,” and advised her to be thankful, even if just for the amount of money she was already getting.

Following this dispute, to see justice done, Inna made up her mind to seek help from the REActor. Once the client stated her case, the REActor offered free legal aid via an online platform. During the session, the legal counsel explained that the woman’s rights had indeed been violated in this case, as described below:

• The living allowance paid to IDPs has nothing to do with accessing social assistance as a single mother;

• Babies born to IDPs are eligible for IDP certification and financial support.

Next, with the client’s consent, professional legal assistance was provided to draft an official letter addressed to the Head of the Social Welfare Department in the city where Inna was staying, pointing out these procedural violations and asking for feedback.

The woman has now been contacted by a representative of this Department and invited to apply for getting an IDP status certificate for her baby. She received a verbal response to her letter and was informed that the employee who had refused her this service in violation of applicable policies and regulations had been officially reprimanded and made to undergo a re-credentialing process for an ad-hoc re-evaluation.

The sister of a client with TB approached the REActor based in a friendly NGO, “100 Percent Life Ivano-Frankivsk” (Charitable Organization), asking for help in dealing with the situation in the school that her nephews attended.

Anna, the Project’s client, is currently undergoing inpatient treatment at a local lung disease center, and the school administration where her kids are enrolled has found out about this. On the basis of their mother’s diagnosis, the school’s administration began to discriminate against the minors on a regular basis. It even threatened to take steps demanding that the kids be removed from the family home. They argued that the “lack of adequate parental care and supervision due to their mother’s illness” required the children to live with their aunt.

Moreover, the school administration repeatedly questioned the health of the client’s children and tried to separate them from other students. On multiple occasions, threats and insults in this vein were made in the presence of the kids and their fellow students, thus negatively affecting both their psychological well-being and academic performance.

The REActor provided an initial legal consultation for Anna’s sister. Apart from that, together with the client’s sister, he drafted a letter to the school administration explaining the provisions of the anti-discrimination legislation and attached an evaluation report detailing the children’s living arrangements and the certification of good health. On top of this, the children were provided with psychological assistance and support by specialists from a friendly organization.

Once the letter was received by the school administration, they immediately discontinued the misguided practice and never again summoned the client’s sister to school or threatened the kids.

Being a sex worker with HIV-positive status and an internally displaced person from the occupied part of the Donetsk region, Yuliia stayed at the Kryvyi Rih Rehabilitation Center. Since the year before, she had been a client of the partner organization, linked to a healthcare facility for case management and ART, and enrolled in the CIRI intervention (accessing support for 12 months).

Six months after being started on the therapy, Yuliia suddenly cut off all communication with her case manager and doctor. After a while, the woman finally contacted the REActor over the phone asking for help. As it turned out, the client had decided to drop out of her rehabilitation program, believing that now she was well able to lead a life of sobriety without any outside help. The woman moved to another region and tried to find a job there, but after a short time, she returned to retaking drugs and quit ART.

Due to such drastic changes, Yuliia’s health suffered a major setback. To make matters worse, one evening, she was attacked by two unidentified men who beat her up and then raped her. As a result, the woman suffered severe concussions to the head and sought professional help from the local General Practice/Family Medicine Clinic. They turned her away, without even providing first aid service, arguing that she had no signed medical services contract (the Healthcare Services Declaration Form) with a local doctor. Next, the woman turned to the district police officer for help but was also refused help and advised to get back to the rehabilitation center.

Yuliia had neither the strength nor the money to return to Kryvyi Rih immediately. So she called up the REActor and asked for help. In the end, the client was brought home through everyone’s efforts. Yuliia was provided with psychological and emotional support, as well as primary legal aid services in a consultation format. She was also accompanied to the health care facility to resume ART. The woman also received medical care from an ophthalmologist, as her eyesight had significantly deteriorated due to the injuries sustained, and she was prescribed the treatment she needed. Yuliia decided against contacting the police to file charges. She is currently back in rehabilitation and continuing her therapy.

Viktoriia was being treated for lymphadenopathy; she was running a high fever and the lymph nodes in her neck were extremely swollen. She turned to her family doctor for help at a local outpatient clinic. During the consultation, the doctor advised hospitalization, but Viktoriia refused due to financial reasons.

After that, Viktoriia informed the doctor about her HIV-positive status. As soon as the words were out of her mouth, the man’s attitude toward the patient immediately changed, and he adopted a dry and curt tone of voice. When he stressed the need for her to see an ENT specialist as well, and Viktoriia asked for a referral and information on where she could get high-quality medical advice, the doctor replied, “How do you even expect to get a consultation with a diagnosis like this?” and mockingly added that the patient should be grateful that she was even talked to in “regular health care centers” and advised her to contact the AIDS center where “the likes of her” are treated.

Viktoriia was shocked by this attitude, but she had to get the referral, so she asked the doctor to provide a referral for the ENT specialist, rather than waste his time sharing unsolicited comments. The doctor replied that he was unable to help her out with this at that point because the computer system was not working. That being so, the client asked that the doctor then give her a paper-based referral note and enter the details into the database at a later point, because she knew from experience that this was standard practice. The doctor carried out this request, although with much reluctance, essentially hurling at her the slip of paper with the referral number, and told her to never come back.

Viktoriia was so rushed to leave his office as soon as possible that she did not even look at what he had written there. Once the woman left the office, she saw that the doctor had written the ICD code B20 with the note “AIDS patient” in the corner of the referral slip.

The client immediately returned to the doctor’s office and asked that he rewrite the referral. At that moment, the doctor was talking to a nurse, and the woman realized that they were discussing her diagnosis. As soon as they saw Viktoriia, they immediately stopped talking and the doctor disdainfully inquired if she had forgotten anything. The woman asked that the ICD code be removed from the referral, but was told no, “Doctors are supposed to know everything about their patient, especially this kind of data, this is a safety precaution.”

That same evening, Viktoriia got in touch with the REActor. The client was provided with legal advice and psychological guidance. The woman was also advised on how to proceed if the doctor and nurse disclosed her HIV status. Later, the paralegal and the REActor filed a complaint with the head of the primary health care center about the discriminatory attitudes experienced by their health care staff, violation of patient’s rights, and disclosure of confidential information. After that, they took up the matter with the head of the center and discussed the situation at hand.

The head of the health care center reacted promptly, and the family doctor was officially reprimanded and warned that disclosure of confidential medical information incurs criminal liability.

Currently, Viktoriia is being served by another family doctor, and her treatment is successful.

Yulia is an HIV-positive woman who has a family and a full-time job in the public sector. When signing her general medical services contract (the Healthcare Services Declaration Form) with her family doctor, the client made a special point of stressing the confidential nature of her medical records and the need for keeping her HIV status undisclosed.

However, in a private conversation with another client, Yulia’s mother, the family doctor informed her about her daughter’s HIV-positive status. From that point on, the girl’s life turned into a “living hell on Earth” – she was completely cut off from her family and her own child, made to use separate dishes and bedding, nor was she even allowed near her child for a hug or a kiss. She was constantly humiliated and abused, with the other family members shaming her and lashing out at her over the HIV status non-stop.

Yulia decided to contact the REActor in a face-to-face setting to find out what remedies are available against this doctor for breach of confidentiality, as well as to get advice on how to improve her life and her relationships with family members.

During her appointment with the REActor, the girl was provided with counseling and information explaining her rights and responsibilities as an HIV-infected person. The REActor clarified for her the meaning of the terms “stigma” and “discrimination”, the liability for allowing those to happen, and for the disclosure of confidential health information, as well as laid out the possible options for addressing these issues. On behalf of the client, the REActor drafted a letter of complaint to the head of the primary care facility involved, describing the family physician’s unethical behavior and its implications for the victim’s family life.

As a result of the investigation into the complaint, the administration of the medical facility sided with the client and officially reprimanded the family physician, having her apologize for her unprofessional conduct. Apart from that, the administration of that medical center suggested that Yulia choose another doctor from among the pool of its specialists, but the girl refused and transferred to another primary care provider.

The REActor also offered to meet and communicate personally with her mother and relatives, as well as to provide consults involving the social workers from the AIDS Center to share objective and accurate information about HIV infection, along with specific lifestyle and treatment advice and guidance for HIV-infected people. But Yulia said she would take things from there and try her best to straighten out her family situation without any outside help.