On the December, 1 Frontline AIDS hold a webinar for a group of partners from Uganda, Nigeria, South Africa, Zimbabwe, and Namibia that received funding in 2022 to pilot emergency response mechanisms in their countries/regions. REAct was invited on this event as well to share its real-life best examples of advocacy implementation in the EECA region, in particular, changes in human rights system and improving of access to HIV services for key group populations.
To date, more then 13 thousand cases have been registered through the REAct system and in this process involved 174 NGOs and 363 REActors all over the EECA region. “Our tool implemented on different levels. On individual one database has to be followed up with some hotline services or emergency phone numbers, because our clients need an immediate support.” – says Victoria Kalyniuk, REAct Coordinator in EECA region. “Then letters, statements and court cases finally. However, the number of these cases is low, unfortunately, due to stigma and discrimination. Clients are not ready to go to the court, they do not trust system. But all the time when REActors talk to the representatives of police, medical or government structures, they influence on attitude to the key groups. That’s also an advocacy method.”
Participants of the webinar expressed an interest in learning more about tool implementation on local and national levels as well. Victoria shares some examples and best practices in region, e.g., in Tajikistan people, who live with HIV face with stigma and discrimination on the domestic level (relatives, partners etc.). REActors in this country choose the way to talk with perpetrators to explain that HIV can be treated and people are not dangerous. Another one good practice on the national level was in 2020 in Moldova. REActors found that there was a discrimination of HIV positive pregnant women in maternity hospital. They were informed that all cases were in the same hospital, from the same medical staff. After the dialog with the head management of that institution, the question was closed successfully.
“There was a great case in Kyrgyzstan” – shares Victoria. “We heard that the police hunts on the clients of OST sites. It became a big barrier for that people, they were just afraid to go there and take therapy. As a result, REActors prepared a letter to a Minister of Internal Affairs and got a response that the situation will be under control on the high level and an internal investigation will be held. That letter was printed and distributed through OST sites and clients. Each time, when the person was obtained by a policeman, he or she showed its copy in the way, like: «Are you sure that you want to do that, because your management will know about it very soon». It helped a lot!
Speaking about best practices on a national level, you should remember that work with stakeholders and presenting your data is must! We collaborate with NGOs, governments, prepare publications and every year implement a new advocacy campaign. Definitely, it takes time to make changes and seems as a top of iceberg, but keep fight for people’s mind! It works!”
Human trafficking, as a serious violation of human rights and freedoms, is still present in Bosnia and Herzegovina. Forced child begging, is one of the most common forms of human trafficking in the country and the tendency to exploit children has not stagnated. The actual situation on the ground, when it comes to children who are victims of forced begging, is much worse than the statistics show. The most frequent locations where human trafficking exploitation takes place are the largest city centers, such as Tuzla, Sarajevo, Zenica, and Mostar.
Children at high risk of being trafficked with the aim of labor exploitation or forced begging often involving Roma children routinely go unidentified. When it comes to the investigation and prosecution of child trafficking, police inspectors and prosecutors tend to categorize cases of child trafficking as other types of a criminal offences. The biggest criticism is directed at the criminal justice system. Especially in the context of the small number of indictments and verdicts for these crimes, light sentences, and weak protection of victims of human trafficking.
However, a positive example is Tuzla Canton, which leads the way in identifying and processing such cases. The Tuzla Canton has a Protocol for dealing with cases of begging, labor exploitation, and other forms of child abuse, which was defined and signed by government institutions and non-governmental organizations.
The Cantonal Court of Tuzla responded to trafficking in children effectively and passed a first-instance verdict of conviction for six defendants for organized human trafficking related to the exploitation of children for the purpose of forced begging and sentenced them to prison terms for a total of 74 years.
The indictment stated that in the period from 2017 to February 2021, members of the organized crime group forced several children between the ages of 4 and 14 to into begging, using theirth mental deficiency, helplessness and inability to resist. The children would be woken up in the early morning, regardless of the weather, transported to various locations in over 25 places in Tuzla Canton or other parts of Bosnia and Herzegovina, supervising them during the begging, and children had to hand over amounts of money to members or group organizers ranging from 40 BAM (some €20) to 150 BAM (some €70) daily. In doing so, the children were exposed to all weather conditions, inadequately dressed and clothed, hungry and constantly under the threat of the use of physical force, or they were beaten and insulted.
There is progress in processing human trafficking cases, but not enough. This is facilitated by a poor identification system, as well as insufficiently developed awareness of this problem. Although human trafficking in Bosnia and Herzegovina has been an ongoing issue, the current efforts will hopefully ensure a reduction in victims going forward.
The case was found in the media at the following links:
In December 2022, the Eurasian Harm Reduction Association (EHRA) publishedMatrix for analysing trends in human rights violations against people who use drugs. The purpose of this Matrix is to facilitate the analysis of documented human right violations by grouping violations into strategic blocks that are easy to use for the subsequent reporting to human rights treaty bodies and/or as part of follow-up advocacy at national level. The Matrix can equip human rights activists with knowledge/skills in how to prepare/ write reports for a human right body. The Matrix aligns the analysis with the environment in which human rights treaty bodies and national governments develop human rights practices, surrounded and mediated by community-led monitoring.
Cases documented through the REAct tool in 2020-2022 in the countries of the Eastern Europe and Central Asia region were included in the Matrix to illustrate human rights violations in practice.
Cases of human rights violations documented through the REAct tool
In 2021, 120 persons newly infected with HIV were registered in Serbia. As in previous years, the largest number of those comes from the MSM population (98% of all those tested).
During the spring of 2022, the news about 20 people suffering from AIDS was shared among young people in Zaječar. Week after week, the news continued to spread like gossip that the number eventually reached 250 AIDS patients, without any corroborating information. The mentioned figure of 250 people represents a number of 100% more infected than the number of infected in the entire country of Serbia on an annual level of 7 million inhabitants, and that in just one city of 40,000 residents. In 2021, 2 HIV-positive people were registered in Zaječar, and the number of 250 would potentially bring Zaječar to the position of a hotspot in Serbia when it comes to HIV-infected people.
TOC* organization wanted to prevent the spread of gossip by publishing educational carousel posts on social media about what HIV is, what AIDS is, what the difference is, how someone can get HIV and how to protect themselves from HIV infection etc. At the end of August and the beginning of September, information began to be shared on social networks, within which the targeting of certain female persons as persons infected with HIV and “sharing AIDS” began. Their names and surnames, as well as photos, began to be shared on social networks, and then the news reached the tabloids. At that moment, the TOC team realized that it was not possible to react only with educational announcements through gossip and targeting, there was also a violation of human rights.
On September 8, the TOC team first contacted a lawyer, and then on September 9, it published a statement in which it invited all injured/targeted persons to contact the TOC team to connect them with the legal team and to initiate a lawsuit for defamation and the honor of the girls who were targeted without any basis or evidence, i.e., lawsuits for a committed criminal offense presenting personal and family circumstances from Article 172, Paragraph 3. In connection with Paragraphs 1 and 2 of the Criminal Code. Also, a compensation claim was filed with the court, in which the injured girls sought compensation for non-material damages for the mental pain they suffered due to the injury to their honor and reputation.
After gathering power of attorney and evidence, and several meetings with a lawyer, on November 16, a lawsuit was filed with the Basic Court in Zaječar. The procedure is currently ongoing, and we will write about its outcome when it comes to an end.
The TOC team believes that it was necessary to react primarily to prevent the unfounded targeting of young people and damage to their reputation and honor, but also to prevent the further spread of false information about the ways of contracting HIV, above all to divert attention to the problem of discrimination faced by HIV-positive people in Serbia, not only by society but also by institutions that should primarily protect the rights of citizens as well.
TOC hopes that the positive outcome of this story will encourage others not to remain silent about the problems they face in terms of human rights violations, and TOC, in cooperation with its partners, will, if necessary, provide all the necessary support to people who believe they have suffered some form of discrimination or human rights violations.
*Timok Youth Center – TOC is a nonpolitical, nonprofit, nongovernmental – civil society organization, set up for an indefinite time to achieve its mission to actively work on the increase of the development of civil society in Serbia, with a special focus on youth.
TOC is founded in 2004 as an organization that deals with the issues of youth policies, development, and support of youth initiatives, encouragement, and guidance of active youth participation in their local communities, as well as the affirmation of healthy lifestyles among young people. The organization has become recognized as a leading organization in the field of activities of local and regional youth coalitions. It is known as a leader in youth policy and support to civil society organizations, non-formal groups, and volunteers.
More than 25 years have passed since the first case of HIV was registered in Kyrgyzstan. As of August 1, 2021, there are 10,807 people living with HIV in the country. And although the presence of the virus has long been no longer a sentence, for all the time only a few have revealed their status. The reason lies on the surface – a greater number of PLHIV are in no hurry to speak openly about themselves, as they are afraid of discrimination, humiliation and insults in their direction. In 2020-2022 alone, the REAct system in Kyrgyzstan registered more than 2,000 complaints about violations of the rights of representatives of vulnerable groups. Of these, over 20% (483 cases) where the victim is a person living with HIV. REAct, together with the Partner Network Association and the Soros Foundation-Kyrgyzstan, is working on documenting cases and providing real assistance to representatives of key groups in order to protect and defend their rights. 15 NGOs that participate in the Street Lawyers project and are located in different cities and regions of the country are constantly monitoring the situation and looking for ways to successfully resolve them.
You live in my flat, so you owe me!
This fall, one of the street lawyers was approached by Safiya (name changed). The girl lives with HIV, worked as an assistant cook in a cafe, but she did not tell anyone at work about her status. Due to the fact that there was no own housing, at some point she moved to a young man with whom she had been in a civil marriage for the past few years.
One evening, her drunken husband came to her work, called her out of the kitchen and demanded that Safiya “arrange” him a table with barbecue and liquor. The client said that she would not do this, because this is an expensive cafe and she does not want to work off this money later. The man began to shout that she lives in his flat, which means she owes him. The security guard of the cafe reacted to it and asked him to leave the place and not draw attention to himself. However, the man refused to leave, ordered 200 grams of cognac and sat down at the bar. Safiya returned to the kitchen and continued to work. Two hours later, the man, having got pretty drunk, made a scandal, started shouting that HIV-positive people, drug addicts and prostitutes work in the institution. The security guard, thinking that the girl could convince her man to leave the cafe, turned to her. The client went into the hall, tried to talk to him. In response, he started beating Safiya and publicly disclosing her HIV status. The guards came running to the screams. The girl was hidden in the kitchen, the police were called, and when they arrived at the place, the guard told them about everything that happened.
Instead of recording everything and taking testimony, the law enforcement officer refused to accept the girl’s statement, citing the fact that in the morning the man would wake up sober and good, and the girl would come running to collect the statement. She will also accuse police officers of inappropriate treatment of her husband. Therefore, he suggested that the administrator of the cafe write a statement against the man and he was only charged with the article “hooliganism”. The fact that he publicly beat the girl and revealed her HIV status, no one even began to take into account! The administrator of the institution refused to write a statement, she said that she did not want trials. The next morning, Safiya was fired from her job, and the man kicked her out of the house.
Real help is nearby
The street lawyer provided the girl with consultations on the topics: “Know your rights”, “Eradication of stigma and discrimination”, “Criminal liability for public disclosure of HIV status”. After that, he arranged for her temporary residence in a shelter that accepts women who suffered from violence. In his own car, the lawyer drove with the client to the house where she lived, so that Safiya took away personal stuff. Later, he gave her a food package and took her to a shelter, where the girl was provided with free accommodation and consultations with a professional psychologist. Now the client is involved as a volunteer of the organization and as a paid employment she is offered to clean the offices of several friendly organizations, thanks to which she can earn about 7,000 soms per month. Alas, she refused to write a statement, because she does not believe that the laws work, that this can give a result and her former partner will be punished. Although the case of Safiya is a violation of human rights in terms of the failure of police officers to fulfill their duties to detain the culprit for hooliganism. The situation can be changedwhen people living with HIV are confident that their rights are similar to others, and stigma and discrimination in society are prevented by raising public awareness, passing laws that protect human rights, and developing free legal services and access to them by members of the community.
For reference:
The Street Lawyers initiative was launched in 2016 in response to actual problems of vulnerable groups. Street lawyers are trained employees of non-governmental organizations in Kyrgyzstan, representing and defending the interests of vulnerable groups, key in the context of curbing the HIV epidemic. In the future, street lawyers were renamed “public defenders”.
This project helps people who are in a difficult life situation. Difficulties in obtaining documents, problems with access to medical services, abuse of authority by law enforcement officers are the main of the many barriers faced by representatives of key populations. A successful case is when a person realizes that his violated rights have been restored. He feels like a full citizen. The problem was solved through negotiations and achieve for the client the restoration of his rights. The main task of street lawyers is mediation. Public defenders act as a conductor between the client and government agencies.
Partnership handshake innovation corporate business concept
The HIV epidemic in Tajikistan is usually divided into three phases: the first lasted from 1991 to 2000, during which time only 37 cases were registered in the country. The second, from 2000 to 2011, is considered to be a period of escalation, when the number of officially registered HIV cases increased by 77 times. The third phase, stabilization, lasted from 2011 until the end of last year, when the growth in distribution increased by 3.3 times. However, if the issue of HIV today can be named controlled, then the level of stigma, non-recognition and discrimination of key groups by the society, until recently, remained extremely high. So far, thanks to the joint efforts of officials and activists, the situation was changed.
The system is hard to change. But you can.
“The case when in front of everyone in line for an analysis, a doctor could shout to a person: “Do you have HIV? Come quickly!”, alas, was not rare. And this is just one of many like it.” – says Farishtamokh Gulova, national coordinator of the REAct system in Tajikistan. According to her, the situation with the violation of the rights of vulnerable groups of the population by medical personnel was extremely difficult: the status of people was disclosed, personal data was transferred to third parties, there was neglect and contempt, especially towards representatives of LGBT and MSM communities. Activists registered these cases, tried to “reach out” to medical staff, including at a higher level, however, the desired reaction did not follow. Until the moment when a new leadership came to the AIDS Center of Tajikistan. Deputy Director – Mr. Alijon Soliev, previously worked in projects himself, was engaged in volunteering, therefore, when he learned about such cases, he immediately showed readiness to cooperate with civil society and determination to stop such offenses by medical personnel.
Let’s act together!
In June of this year, REActors were able to discuss the most common situations with Mr. Soliev. So, one of them took place in the area of republican subordination, the city of Tursunzade. The wife of a person living with HIV received a call and was told, “Your husband has the virus, you should come with your children and get tested. You need to understand whether you have HIV or not.” At that time, the woman did not know about his status – he was in migration. Upon his return, the man talked to his wife, but the infectious disease specialist continued to call her and bother her with demands to come. This made husband very angry; he did not want his wife to be told about HIV in such a tone and decided to find out everything himself. Upon arrival at the local AIDS Center, there was a conflict: instead of an apology, the epidemiologist got rude to the man. He fixed everything and turned to the REActor for help. According to Farishtamokh, she told Mr. Soliev about this case on Saturday, and on Sunday he gathered all the doctors for an online meeting. As a result, the doctor who created a conflict situation and disclosed the man’s HIV status was reprimanded.
Another case of status disclosure involved a trans person from the Khatlon region. She returned from Russia in July, got registered in Dushanbe, received ARV therapy for three months and left to work in Turkey. The family did not know about her HIV status and would have remained so if the laboratory assistant at the AIDS center had not been a relative and had not recognized her. For disclosure of the status of the client, and negligence, the employee was reprimanded. Of course, such cases help to improve activities in the regions and increase the level of information on all sides of the situation. Lack of experience and mentality play an important role in ALL patient care cycles in AIDS centers.
“Mr. Soliev asked to be immediately reported if even the slightest offense is recorded: refusal to issue certificates or certificates, negligent attitude to tests, rude treatment when issuing ARV drugs…” Farishtamokh adds. “We are well aware that top management cannot control everything – there are 66 AIDS centers in the country, but thanks to the work of REActors, it has become possible to identify and correct the situation.”
“Obviously, civil society in Tajikistan is now being heard and seen. We are invited, we are consulted – it means a lot.” – Pulod Jamolov, head of the SPIN Plus organization, comments on the situation. “And I can confidently say that such cooperation between the authorities, represented by representatives of medical structures and civil society, together with REActors, really changes the situation within the country.”
Every year on December, 17, sex workers, their advocates, friends, families and allies celebrate the International Day to End Violence against Sex Workers. At first, this date was conceived as a memorial in honor the memory of the victims of the killer from Green River. In the post-Soviet region, it was proposed to celebrate this day by the Sex Workers’ Rights Advocacy Network (SWAN).
REAct will join the Day to End Violence Against Sex Workers events and publish the collected evidence of violations of the rights of this vulnerable group in Kyrgyzstan, the country that managed to record the largest amount of evidence in the EECA region thanks to the effective work of non-governmental organizations and communities. We also publish the story of one of the clients who applied to illustrate the vulnerability and insecurity of sex workers.
Only during the 2020-2022, the REAct system in Kyrgyzstan registered more than 1,300 reports of violations of the rights including representatives of this key group.. More than 50% (668 cases) of registered cases reported violations of rights and discrimination by representatives of law enforcement agencies. Of the 668 cases, 34%of violations were reported by sex workers.
Sex work itself is not criminalized in Kyrgyzstan. However, everything related to it is connected, including the organization, may fall either under the norm of Art. 166 of the Criminal Code of the country – “involvement in prostitution”, or under Art. 167 – “promoting prostitution and debauchery.” Thus, in fact, sex work is criminalized and highly stigmatized. And alas, first of all, by the girls themselves.
For your help you will be punished
January 2022. Nazgul Baidovletova, public defender, «ZiOM21» Public Foundation, Talas (Kyrgyzstan) was approached by Amina (name changed). She and another girl (both sex workers) were beaten by clients. As it later became known, they wanted to rape her friend – Amina stood up for her, for which she paid such a high price…
Nazgul says that she immediately offered to write a statement and see a doctor, but the client refused. The reason for this was … the rapists themselves – it turned out that they were her acquaintances and the girl did not want to create problems and attract too much attention. Only on the third day, when the pain became unbearable, she again dialed the number of the human rights activist. Amina was immediately taken to a friendly doctor. The condition was terrible: bruises all over the body, eyes filled with blood, abdominal pain – he immediately recommended to go to the hospital. Nazgul began to emphasize again that such a case should not be ignored, and that those responsible men should be punished. But again she was refused – it seemed to the client that everything was not so serious and it was not worth exaggerating.
At the hospital, Amina was first seen by a traumatologist, but did not find anything in her profile and was redirected to a gynecologist. Examination and ultrasound in the women’s department gave a disappointing verdict – an urgent operation due to hemorrhage in the uterus. After it, the situation changed – the girl agreed to write a statement, but at the same time she called the offenders, in the hope that they would answer and help. But to no result.
We pay and the case is closed
According to the law, the gynecologist who took Amina signaled to law enforcement agencies that a patient with such a serious diagnosis was admitted, but they were in no hurry to respond. On the same day, Nazgul also applied to the district department of internal organs, but the request remained unanswered. Only the next day the police arrived and accepted the statement from the victim. But at that moment, the rapists got in touch with Amina. Upon learning that the girl turned to the authorities for help, they offered her to pay the costs of the operation if she wrote a counter statement and the case was closed. They began to put pressure on the fact that they are familiar, that they work in such an area … The girl had doubts – is she doing the right thing? As a result, Amina succumbed to their persuasion, accepted the money (the amount of 20 thousand soms, which is similar to 200 dollars) and the issue was closed.
But everything could be different
Obviously, without the intervention of paralegals, the case would not have reached law enforcement at all. However, the situation could have gone in a different, more significant “scenario”. According to the Istanbul Protocol, Kyrgyzstan has developed and implemented the ”Practical Guidelines for Documenting All Types of Violence”, according to which, when contacting a medical institution, any type of violence must be recorded by a doctor in a special form. And if the police representatives immediately responded to the call from the hospital and the appeal of the defender, took the testimony of the victim – for violators it would be a completely different article. Plus, the harm done to the health of the client has not been fully determined. But alas, the moment has passed.
Aisuluu Sharsheeva, mentor of the Street Lawyers project, comments on the situation: “When considering this and other similar situations where sex worker violence occurs, we should not miss an extremely important point – the self-stigma of our clients. Because of it, they are ready to endure pain, just not to go to the doctor, to forgive aggression and humiliation, because “such a category, they can treat us like that.” That is, instead of upholding the rights – in fact, to depend on violators. Girls are really extremely vulnerable, but they should not give up. This category must firmly change its approach, fight for its rights, otherwise everyone will forget about their existence. SWs should be understood and remembered, despite the cruel and inhuman treatment, everyone has the same rights and must be implemented.”
For reference:
REAct in Kyrgyzstan is being implemented in partnership between the Partnership Network Association and the Soros Foundation-Kyrgyzstan. Cases are documented by 15 NGOs that participate in the Street Lawyers project and are located in different cities and regions of the country.
The Street Lawyers initiative was launched in 2016 in response to actual problems of vulnerable groups. Street lawyers are trained employees of non-governmental organizations in Kyrgyzstan, representing and defending the interests of vulnerable groups, key in the context of curbing the HIV epidemic. In the future, street lawyers were renamed “public defenders”.
This project helps people who are in a difficult life situation. Difficulties in obtaining documents, problems with access to medical services, abuse of authority by law enforcement officers are the main of the many barriers faced by representatives of key populations. A successful case is when a person realizes that his violated rights have been restored. He feels like a full citizen. The problem was solved through negotiations and achieve for the client the restoration of his rights. The main task of street lawyers is mediation. Public defenders act as a conductor between the client and government agencies.
By the Strategy of Montenegro for the Prevention of Drug Abuse 2013-2020 addiction treatment is conducted within the health care system in the country, and rehabilitation measures aimed at social reintegration and maintaining achieved abstinence are carried out in the social security system. Treatment is planned and implemented in accordance with the needs of each individual and changed, if necessary, in relation to the condition. During the treatment only professionally justified and validated procedures should be used. That means guidelines for the treatment of addiction are necessary, as well as quality standards in relation to treatment introducing in the institutions that provide such services. Also, buprenorphine substitution has not yet been introduced into regular practice in all centers for substitution therapy, as well as changes in healthcare system bring unexpected and not always positive moments to the key groups populations.
Interrupted treatment… due to the health system
On August, 2022 a user of substitution therapy (OST) contacted REActors with a complaint that his right to health treatment was violated in the way that the distribution of the drug buprenorphine, which was prescribed as a therapy for opioid addiction by a psychiatrist, was interrupted. Due to the changes in the functioning of health system of Montenegro, which is reflected in the abolition of mandatory health insurance and the payment of contributions for the same, as a result of which the Health Fund, as an institution responsible for the procurement of medicines, was left without funds for their purchase, it was difficult to provide many medicines. And so also in this particular case, when there was a cessation of therapy for people using a substitution drug.
Massive work of REActors
Immediately after receiving the notification from the patient, representatives of NGO CAZAS contacted the competent institutions to check the credibility of the complaints. They tried to react as soon as possible with a press release that was carried by all relevant media and with which they informed the public about the massive violation of the rights of OST patients and called on the authorities to solve the problem as soon as possible. REActors also informed the user who contacted them of his rights, and gave him a copy of the complaint form to the health institution. With this support, the user filled out a complaint, which REActos sent to the health institution.
Thanks to the quick reaction of the members of the organization, sending of press releases and contacting of health institutions, the therapy for OST users continued already the next morning. Complaints submitted to the health services are awaiting a response.
Doctor man consulting patient while filling up an application form at the desk in hospital. Medicine and health care concept
In 2013 Ministry of Health, Montenegro adopted Strategy for the Prevention of Drug Abuse 2013-2020 which proclaimed that country provides conditions and environment in which there is no place for discrimination. However, the reality shows that the situation is reverse – stigma and discrimination against people, who use drugs are still the largest obstacles to prevention and providing the necessary measures for the rehabilitation of affected persons.
“You’re a liar!”
On June, there was a violation of the rights of the patient Sofia (name was changed), who is a woman, who use drugs and user of the OST service. The violation of her rights as a patient occurred in the way that she was exposed to the doctor’s unprofessional attitude and inappropriatecomments during her visit to the infectious disease clinic. A few days after the event, she contacted REActor, complaining about the doctor’s attitude towards her on the medical examination. During the meeting with the REActor, the patient explained that in the earlier period she was involved in the treatment of HCV treatment, which at that time in health system of Montenegro consisted of pegasus drug therapy, with which a 100% cure is not possible. During the conversation, the patient explained to the doctor that she was positive for the presence of the HCV virus at the last test. She also informed the doctor that she followed the rules and avoided risky behaviors and regularly tested for the presence of psychoactive substances, but despite everything, it was again positive. Sofia explained that in the meantime she had a child and that she had an additional obligation to solve the problem. The doctor reacted negatively to everything she told. He accused her of lying and of using psychoactive substances again. The patient understood from his story that he did not want to include her in the treatment process to which she is entitled and was disappointed because he used offensive words at times.
Situations won’t be repeated
After the conversation and in agreement with the patient, the NGO CAZAS requested and held a meeting with the director of the infectious disease clinic, where she was informed about the situation and received assurances, which were later confirmed, that such situations would not be repeated and that the patient would be enabled to enjoy all the rights she has the law guarantees. REActors decided on this approach after talking with the client, because together they came to the conclusion that this is the best option at the moment, considering the fact that the patient must be involved in HCV treatment through the infectious disease clinic. The patient expressed her fear that the initiation of a more serious procedure would not negatively affect that process, if the treatment was conducted by the same doctor from whom she experienced discrimination. Although REActors guaranteed her that they would enable her rights as a patient to be respected in the regular and legally prescribed procedures, as a measure of compromise in this agreement, the patient was assigned another doctor at the infectious disease clinic.
***
By the records from 2014, among the population that is using drugs, 53 percent is infected by hepatitis C. In 2018, the positive list of medicines had 1156 medicines available publicly through the Health Insurance Fund. The list has been expanded with 114 new medicines that cover a wide range of diseases: hypertension, diabetes, cancer, thrombolytic therapy, new medicines for infectious diseases such as HIV and hepatitis C, medicines for transplantation, autoimmune diseases and mental disorders.
Despite that Bosnia and Herzegovina is one of the leading countries of the South Eastern Europe, hate speech, intolerance towards LGBTI persons, as well as harassment or violence remain very common and still is an issue of concern. However, a significant step toward not only increasing the LGBTI community’s trust in government institutions but also strengthening standards and legal understanding of discrimination was made this year in Bosnia and Herzegovina.
The first judgment establishing discrimination based on sexual orientation, gender identity and sex characteristics in Bosnia and Herzegovina was passed on April 4, 2022. According to a lawsuit filed and conducted by the Sarajevo Open Centre* as one of its strategic one, the trial lasted a total of two years and six months and is significant, because now there is a judgement protecting LGBTI rights in BiH for the first time in 13 years since the Anti-Discrimination Law was passed. This judgment is also crucial because the defendant, acted in a discriminatory manner as a public figure or cantonal representative in the Sarajevo Canton Assembly.
The defendant violated the right to equal treatment in relation to members of the LGBTI community whose rights the SOC protects as a plaintiff, by making a statement on the social network Facebook reading: “…Fifteen of them are sufficient to launch an initiative and organise so-called pride marches aimed at destroying the state and its people. Everyone has the right to live their lives as they like, but we also have the right to choose who we want to live with. I want people like these to be isolated and put away from our children and society. Let them go somewhere else and make a city, a state, and a law for themselves, and their own rights that no one will dispute. But NOT here!”.
The judge found that the defendant committed the following forms of discrimination: inciting and issuing an order for segregation, harassment with the intent of violating a person’s dignity and creating intimidating, hostile, degrading, humiliating and offensive content based on sexual orientation, gender identity and sex characteristics. The judge emphasized that the text of the statement is extremely discriminatory and degrading, based on extreme negative stereotypes, and that it should be distinguished from statements and posts made by unknown and politically uninvolved individuals because the defendant, as a public official, should protect the freedom and dignity of every individual in a realistic and authentic manner, refraining from expressing views such as “I want people like these to be isolated and put away from our children and society” because it represents a lack of respect for others, and the statement itself is hate speech and direct incitement to hatred, which is altogether discrimination. The defendant’s statement harmed the dignity of LGBTI people, i.e., the plaintiff, and created a hostile, degrading and insulting environment, which violates the ADL, the ECtHR and European case law that is binding in Bosnia and Herzegovina.
It should be emphasized that this is a first-instance judgement, not a final one. However, this precedent is a significant step toward not only increasing the LGBTI community’s trust in institutions but also strengthening standards and legal understanding of discrimination.
* – NGO Sarajevo Open Centre works to advance human rights, especially the position and human rights of LGBTI people and women in Bosnia and Herzegovina, through representation of their realities and advocacy for legal, policy, economic, social and cultural changes in all areas of life.
Illegal is the detention committed in the absence of the listed grounds for its application or in violation of the procedural order (for example, without drawing up a protocol of detention). The corpus delicti is formal. The crime is considered completed from the moment of illegal detention.
Competent persons and citizens for their illegal or unjustified detention or abuse of authority during detention are subject to liability established by law. According to Article 234 of the Criminal Code of Uzbekistan, knowingly illegal detention can be punished with imprisonment of up to 1 year.
The clients of the REActors were detained in the evening in Tashkent, in the park of Babur. They walked, and later sat down on a bench. After some time, a representative of the Milliy Guard (the National Guard of the country) approached them and said that he had been watching them for a long time and, in his opinion, they were behaving very suspiciously. After that, he called three more employees of this unit. Then the clients began to be interrogated, threatened with insulting words that there are cameras everywhere and they recorded everything. That now the police will be called and the detainees will be handed over to them. The clients didn’t mind. Representatives of the internal organs arrived, they were taken to the district office. There, two representatives of the police organized an interrogation, photographed and fingerprinted, and released them three hours later.
Clients were consulted on human rights. They do not mind making a statement if law enforcement officers start calling them again on this issue. At the moment, contact with them is maintained.
In addition to interrupting therapy, the resumption of treatment also poses a threat to human health, as resistance (virus resistance) to treatment can develop in the body. It can also lead to side effects and psychological complications.
During the client’s treatment at the Specialized Infectious Diseases Hospital, namely consultations about his adherence, a problem was identified. The low adherence of a person was caused by the fact that law enforcement officials deprived him of the right to take ART for the period of his detention for 15 days. These cases were repeated more than once, which over time caused a deterioration in health and an increase in viral load.
The reason for the client’s arrest was his own sister, with whom they live in their parent’s apartment, conflicts occur between them with corresponding consequences.
The person received counseling on the treatment of HIV, the concomitant disease of hepatitis C, as well as on the rights of PLHIV, their assertion and obtaining disability due to illness. Then he was redirected to consult a lawyer to resolve legal issues and solve life situations.
Last year alone, 70 cases were registered in Uzbekistan, in which the victim is a man who has sex with man or is trans*. Tiberius project staff helped the REAct team to document cases of rights violations in the LGBTQ community. Unfortunately, statistics show that in most cases, violators are extremely difficult to bring to justice, or they are not identified as such, as clients refuse to develop situations, fearing publicity and further discrimination.
The client (MSM) and his friend (sexual partner) lived together in a rented apartment. Neighbors, guessing about their relationship and their non-traditional orientation, at any opportunity insulted, humiliated and dishonored men, demanding that they immediately move out of the apartment, otherwise they would turn to the police, because they do not want to live in the same house and have their children communicate with “such” as they are. The client and his friend had no choice but to find another place of residence as soon as possible and move out, because the neighbors didn’t let them pass at all.
The client and his friend were asked to write a statement about the neighbors who insulted them. They refused, fearing publicity and persecution by law enforcement agencies. It was suggested to talk to the neighbors and explain about the responsibility for violation of human rights. But they also refused, preferring to move out of there as soon as possible and not get involved.
Alas, the number of cases of abuse of power by state executive bodies still remains huge. Especially in relation to vulnerable groups of the population. These situations, in the main, go unpunished, due to the fact that clients fear for their lives and revenge from those who should… protect them.
The client (PWID, former prisoner) was at home when the criminal investigation officers came to him and, without explanation, he was taken in handcuffs to the district department of internal affairs. There he was beaten and asked about some kind of gold chain and money that he allegedly took from a neighbor. It turned out that last night someone attacked his neighbor in the street and took away all the money and the gold chain. Due to being a PWID client and ex-prisoner, he immediately fell under suspicion. The man was kept at the department for two days, periodically “knocking out” evidence from him, and then, without explaining anything, he was released. It turned out that he was lucky, because the real robber was caught.
The man was consulted on human rights issues and was asked to write a complaint against law enforcement officers for unlawful arrest and beating. However, he refused to consult with a professional lawyer and did not want to write a statement, because he does not trust and was afraid of persecution for drug use by the authorities.
In situations of refusal of medical care, be sure to ask for a written document with the conclusion (refusal) of the doctor, head of the department based on the results of the appeal. Further, you should immediately contact the head physician in order to minimize the time for a possible solution to the problem. You need to try to document all actions in a medical institution, so that later there will be evidence to defend your rights in higher authorities.
During the course of treatment in a specialized infectious diseases hospital, the client told the REACtor about his problem. He said that in addition to HIV, he has an incurable disease called lupus, which must be treated so that there are no complications. At his place of residence, he took the necessary documents and went to Tashkent, to the dermatovenerological hospital. There, during registration, they found out that he had HIV infection and refused, referring to the fact that they did not have a place and that he needed to be treated elsewhere, at his place of residence in the region.
During the consultation with the REACtor, the client received the necessary information on the issues of HIV treatment and prevention, as well as on the rights of PLHIV, and was further referred for consultation with a lawyer in order to investigate this case. He went to the hospital again, with a referral, already informed by the lawyer how to defend his rights. And as soon as they wanted to refuse again, he began to do it. The client informed that in case of repeated refusal of treatment, he would apply directly to the Ministry of Health with already prepared complaint documents. The medical staff got scared, and the client was put on treatment in turn.
On November 17-18, 2022, Tbilisi (Georgia) hosted the Fourth Forum of Judges of the EECA Region on HIV, Human Rights and the Law, organized by the country’s High School of Justice, together with UNDP, WHO, UNAIDS and other partners. The purpose of this event was to discuss and analyze key urgent factors, namely:
– study of the latest scientific, medical and epidemiological data;
– access to and awareness of people living with HIV and other key populations for judicial and legislative responses at the national, regional and international levels;
– problems and experience of their solution in the field of protecting the rights of people living with HIV, as well as other vulnerable groups.
Among the invited participants and speakers are judges, representatives of the National Institute of Justice, coordinators of the UNDP country office on HIV, health and development from selected EECA countries, including Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Tajikistan, Ukraine, Uzbekistan.
The session of the second day caused a special resonance among the Forum audience: “HIV and human rights. Access to Justice“. It was there that Anna Dovbakh, Executive Director of the Eurasian Harm Reduction Association, presented cases of violation of rights and freedoms collected by the REAct tool on behalf of the communities of the EECA region. The presentation “Access of people living with HIV, affected by TB and key populations to justice, including in context of armed conflicts and other emergencies” fully demonstrates the egregious situation in the region with legal mechanisms. According to the statistics that was managed to record for 2020-2022, in 5 countries of our region, only a small part of the recorded cases reach the court, and every third case is associated with violations of rights by law enforcement agencies.
“With my speech, I wanted to emphasize the special conditions in which our communities find themselves when faced with the legal system. And alas, they are not in our favor,” Anna says. “People do not want to go to court because they simply do not trust the state system. Self-stigma and discrimination also do not help to bring the matter to the end – it is easier for a person to remain silent than to defend his own by right.”
Ganna Dovbakh
Among the main barriers to access to justice were:
● Particularly vulnerable position of women from risk groups.According to the World Health Organization, one in three women experience intimate partner violence. Women who use drugs are five to twenty-four times more likely to experience gender-based violence than women in general. Only 40 percent of women survivors of violence seek help and only 10 go to the police. Support services for women in situations of violence should take into account the experience of each woman, be accepting and non-discriminatory.
● Drug use as an aggravating factor – if a person from the community is under suspicion, often the authorities put pressure on him, blackmail, dictation, discrimination and falsification;
● Inefficiency of state-guaranteed legal aid – there are no lawyers or they are not at all interested in their case. Or they demand money for their services;
● Application of criminalizing laws – if a person knows that he can be sued for illness, sexual orientation, use of psychoactive substances, he will not go to court as a system to protect his rights, because he is sure the law is not on his side.
“And this is just the tip of the iceberg, because it turns out that REAct clients are the defendants, not the plaintiffs.” Anna adds. “What should be implemented in the near future? Definitely, the maximum introduction and expansion of assistance on the principle of “peer to peer”: documentation by paralegals of cases of human rights violations, analysis of systemic legal trends, development of an advocacy base, which will lead to improved access to medical and social services. I believe that raising awareness, decriminalizing HIV and reducing the risk level in criminal law will lead to building trust in the state bodies of our region on the part of our key groups.”
Infection with HIV infection through the blood (parenteral route of transmission) occurs when infected blood enters the body – directly into the bloodstream, skin damage and mucous membranes, in contact with blood and other fluids, tissues and organs of the body.
The client turned to REACtor during her treatment in a specialized infectious diseases hospital. She said that in December was a car accident, where she received injuries that require surgery and a blood transfusion. After treatment and rehabilitation, the woman was discharged home. Six months later, her health began to deteriorate. The client went to the doctors, underwent medical examinations, but they did not give results. Then she was offered to take a blood test for HIV and as a result the test was positive. The woman was in shock – she is a married woman, has children, had no other relationship. When interviewed by an epidemiologist about whether she had any medical manipulations or operations, the client replied that she had an accident and received a blood transfusion. After that, the woman was registered and began her treatment.
The client received the necessary advice regarding her health and HIV treatment, further on the rights of PLHIV, consulted a psychologist and was referred to a lawyer. The lawyer, having studied the whole situation, offered to help draw up an application and file a lawsuit against the hospital in which the operation was made. But alas, the client refused, because she did not want anyone else to know about her HIV status and this would bring problems to her family and loved ones.
Disclosure of medical confidentiality is the disclosure of such information to at least one person (with the exception of the patient himself, his legal representatives or the medical staff involved in the treatment of this patient). It does not matter who they became known to: a friend, a colleague of the victim, or strangers.
While undergoing treatment in a specialized infectious diseases hospital, a client turned to the REACtor. During counseling, he told his story. Being at his place of residence, one day a patronage nurse asked him where the person lives and named the client’s full name. The man did not show that he knew who it was and that he lived there. Then he asked why the nurse was looking for a person. The woman replied that he hasAIDS and he needed to urgently come to the district clinic for a medical examination and a note from an infectious disease doctor.
After the client was consulted at the REActor on the prevention and treatment of HIV, as well as on the rights of PLHIV, in order to further resolve the problem of disclosing his status, he was referred to a lawyer for advice and step-by-step actions. Upon returning home, he turned to the head physician of the district clinic about the situation that had happened to him and this nurse. The head doctor asked for forgiveness for his employee, and the nurse herself repented and apologized for her misconduct. Since other outsiders were not witnesses to this event, the client forgave her, but with a warning that if such an action is repeated, he will demand proceedings and go to court.
