Tag: Discrimination

Not here: refusing to hospitalize a person living with HIV in North Macedonia

Post author By velyunsky
Post date January 30, 2023

The rights of people living with HIV, particularly their health rights, are routinely violated in the Republic of North Macedonia. An analysis of reported cases to NGOs working in this field reveals that approximately 90% of human rights violations of people living with HIV are related to their health rights, and the perpetrators are medical professionals. The health rights of people living with HIV are being violated either by disclosing their HIV status or, in this particular case, by refusing to provide them with health care.

Not here!

During an examination at the Clinic for Infectious Diseases and Febrile Conditions – Skopje, the patient was advised to go to the University Clinic for Dermatology. Certain serious skin changes (pyoderma) indicated that the person needed to be admitted to the Clinic for Dermatology right away, at which point a specialized doctor was contacted by the Clinic for Infectious Diseases and Febrile Conditions, and an appointment was scheduled. In the presence of the patient, the doctor was starting the administrative procedure for patient admission at the Clinic’s reception desk, and he reminded the nurse that the patient has an immunodeficiency. The department nurse reacted angrily, questioning why the patient had not been admitted to the Clinic for Infectious Diseases instead, how he would stay with the other patients at the Dermatology Clinic, and how she would inform the other patients that one of the hospitalized patients has AIDS. The doctor informed the nurse that the patient has a dermatological condition and must be admitted to the Clinic for Dermatology. Furthermore, he stated that other patients cannot and are not permitted to know about his HIV status. Meanwhile, the patient needed to use the Clinic’s restroom. After exiting the toilet, he was met with a slew of inconveniences by the medical staff, such as remarks that others would now be unable to enter after him, that the toilet needed to be disinfected, and so on.

Even though the patient was aware that he should be admitted to the Dermatology Clinic, the doctor arrived after a long wait, informing the patient that he would still have to be admitted to the Clinic Infectious Diseases and that for “some” reason he could not be admitted to them. The patient believes that, despite the doctor’s good intentions and recognizing that he had a dermatological problem, the refusal to hospitalize him came from the nurse.

REAction and outcome

Because the patient chose not to pursue the violation in court, the Association for the Support of People Living with HIV “Stronger Together,” Skopje, decided to address the infringement of rights by writing to the director of the Clinic for Dermatology. The letter outlined the case while enumerating all domestic legislative rules concerning discrimination and patient rights. The Association demanded that measures be taken by the Clinic to sanction the violating behavior of the Clinic’s staff and prevent similar situations in the future. It also offered support in providing sensitization training to doctors and nurses, to prevent any future incidents of human rights violations in the Clinic. After a few days, the director of the Clinic for Dermatology called the Association’s executive director to inform them that they were aware of the situation before the Association sent a letter and that the nurse would be sanctioned. The Association has yet to receive written confirmation of any sanctions imposed on the nurse, and it intends to inquire whether the Clinic for Dermatology imposed any sanctions.

Relevant legal provisions

According to Article 5 paragraph 2 and Article 32 paragraph 4 of the Law on Protection of Rights of Patients, medical professionals are prohibited to discriminate against anyone based on their health condition. Such prohibition is also regulated in the Law on the Protection from and Preventing Discrimination.

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Spread of panic and false information about the increase in the number of people infected with HIV in Zaječar

The first judgment for discrimination based on sexual orientation in Bosnia and Herzegovina

Tags Discrimination, Human Rights, North Macedonia

Response stories

Change for the better: how REActors and government agencies in Tajikistan are jointly changing the situation with human rights violations in the country

Post author By velyunsky
Post date December 20, 2022

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.”

Unprofessional attitude of medical stuff in Montenegro that brings to the violation of rights

Post author By velyunsky
Post date December 16, 2022

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 inappropriate comments 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.

Insults and humiliation due to sexual orientation

Post author By velyunsky
Post date November 20, 2022

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.

Original Source (in Russian)

Attempts to “knock out” a confession from an innocent man

Post author By velyunsky
Post date November 20, 2022

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.

*PWID – people, who inject drugs

Original Source (in Russian)

“This is just the tip of the iceberg!”: the voice of communities is heard at the Fourth meeting of the EECA Judges’ Forum on HIV, Human Rights and the Law

Post author By velyunsky
Post date November 18, 2022

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.”

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.”

*Among the NGOs that participated in the study:

HIV Legal Network

ECOM

SWAN

EHRA

Access to justice in the EECA region for key communities presented at the 3rd EECA Judges’ Forum

Tags Discrimination, HIV, Human Rights, Stigma

Response stories

Nothing Personal, Just Prejudice: Complaint to Director of Clinic in North Macedonia

Post author By velyunsky
Post date November 3, 2022

Nothing personal, just certain prejudices

Nowadays, North Macedonia is a country with low prevalence and concentrated epidemic of HIV. However, the number of cases is increasing, the percentage of people, living with HIV who are aware of their status, is around 60 %, which is way below the goal set by the United Nations. There is still no research on stigma index, but if one is to evaluate the media reporting on the matter of HIV, we can conclude that there is a high level of stigma and discrimination as well. What to do if your status has been revealed and should you react or face it alone in silence?

Tittle-tattle with a social impact

A person employed in one of the university clinics in the country did an HIV test in the laboratory, where he got a positive result. The test result of the HIV test must be confirmed and assessed by a doctor, however very shortly after that, he realized that the information about his HIV status has been shared with most of his colleagues. It was spread around the clinic as a gossip and violated his right to privacy. What’s more, positive results from viral markers had already been entered into the medical system, although, according to Protocol until confirmatory tests were done at the University Clinic for Infectious Diseases and Febrile Conditions/Institute of Public Health, the results cannot be considered confirmed and no diagnosis must be entered in the patient’s medical record.

Flagrant violation of privacy

Some of his colleagues immediately changed their attitude towards him, openly letting him know that they no longer wanted to work with him, because they were afraid that he would transmit the virus to them somehow and that he was a danger. He faced rejection from certain colleagues, humiliation and avoidance. He was extremely surprised that as medical staff, his colleagues were not aware of the way of the HIV transmission. He immediately spoke openly with some of them and tried to explain that there is absolutely no way that it can be transmitted through air, touch, use on the same toilet, cutlery, equipment, etc. And that there really is no potential danger of them getting HIV just because they work in the same workplace, nor that there is any danger in relation to patients receiving health services from his side. His efforts were unsuccessful and certain colleagues continued to behave rudely and humiliatingly with the intention of forcing him to quit his job.

The patient’s rights were also violated in relation to the release of a professional secret, that is, even though he was an employee, he, as a patient, requested a health service: HIV testing within the Clinic, which violated his rights to health care and he faced discrimination as well. In his case, the results of the HIV test were shared with almost all of his colleagues, which is a flagrant violation of privacy and the duty of professional secrecy by the doctor who processed his HIV test data. And all this, because it is about the HIV (a type of health condition about which his colleagues apparently have no knowledge, only prejudices) they assumed that once he was HIV positive, he must be a homosexual as well.

Immediate REAction and positive outcome

The Association for the support of People Living with HIV “Stronger Together”, Skopje, heard about this case and decided to take a control on it. Its representatives prepared a letter, that was sent to the Director of the clinic, who was understanding and very professional. After, some of the colleagues were called to a meeting with him, where they were informed about all the aspects mentioned in the letter (rights of workers, the obligation of non-discrimination in the workspace and the modern aspects of the HIV, including the undetectability = untransmittable).

As a result of the letter and the director’s actions, after one month of returning to the work environment, the person reported no stigma and unequal treatment from colleagues and employers. The client still works in the university clinic.

Lawyer’s comments

1. Is a disclosure of status a crime in the North Macedonia? What punishment would people receive if the victim would go to the court?

– The Criminal Code does not contain a specific provision that would constitute disclosing an HIV-status a crime. However, depending on the person who have disclosed the status, that person can be charged for Abuse of personal data, pursuant to Article 149 of the Criminal Code, or Unauthorized disclosure of professional secret, pursuant to Article 150 of the Criminal Code. Depending on the circumstances and the crime, the punishment is either monetary, a prison sentence of one year or three years. The disclosure of personal data, specifically medical data, is also prohibited with the Law on protection of rights of patients.

2. What are restriction for people with HIV regarding professions regarding the North Macedonia legislation? Would this person be able to continue working in laboratory?

– There are no restrictions for people with HIV regarding professions in the Republic of North Macedonia. As a matter of fact, the Law on Labor Relations and the Law on Preventing and the Protection from Discrimination prohibits discrimination based on a person’s health condition. However, all candidates for work positions and employees must disclose health conditions that might prevent them or limit them in completing their work tasks. Although there are no cases so far regarding this provision and employees who are living with HIV, this provision might be misused by employers with respect to HIV-status of employees or potential employees. Notwithstanding that, it would be unproportioned invasion of privacy, and by default unlawful, for employers to use this provision and ask employees or future employees to disclose their status. Speaking about the continuation of work – yes, the client can continue working in the laboratory and still is.

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Letter to the Director of the Clinic

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