The recent change in the procedure of the Institute of Health Insurance of Herzegovina-Neretva Canton (ZZOHNK) for scheduling and conducting examinations from primary to specialist healthcare in health institutions within the canton has resulted in a positive outcome for the people, which was largely due to the public’s reaction to the initial controversy over the changes.
The procedure, which aimed to divide patients based on their nationality, received a strong outcry from citizens, NGOs, and political parties who argued that it violated basic medical postulates and oaths, and numerous positive legal regulations governing the field of healthcare. The cancellation of the controversial healthcare procedure in Herzegovina-Neretva Canton is a victory for the patients’ rights to receive equal and non-discriminatory healthcare. This decision has reaffirmed the fundamental principle that patients have the right to choose their preferred healthcare providers, and that nobody should be separated or discriminated against based on their nationality or any other personal characteristic.
The success of this story lies in the power of the people to stand up for their rights and demand accountability from their institutions. Without the collective efforts of citizens, NGOs, and political parties, this discriminatory procedure could have been implemented, and patients could have been denied access to healthcare facilities based on their nationality. The cancellation of this procedure serves as a reminder that the people’s voice is powerful and that their actions can bring about positive change in society.
The public outcry against the procedure reflects the collective will of the people to ensure that their basic rights and values are respected by the institutions responsible for providing them with essential services. It sends a clear message that discrimination and segregation have no place in modern society, especially in the field of healthcare where access to quality care is a fundamental human right.
March 3rd is International Sex Worker Rights Day. Its history began in 2001 when over 25,000 sex workers gathered for a festival in India. The event was hosted by the Durbar Mahila Samanwaya Committee, a Calcutta based group, representing the interests of more than 50,000 sex workers and members of their communities. Since that time, March 3 is celebrated all over the world.
But even though the global society is developing as quickly as possible, in many countries sex workers are seen as criminals and “fallen” people, causing “undermining of traditional values”. Alas, the region of Eastern Europe and Central Asia is no exception. Justifying themselves in this way, governments in some countries support the criminalization of sex work and campaigns aimed at discriminating against the rights of this key group. And even where sex work is not subject to any administrative or criminal prosecution, police raids, violence, humiliation, and insults from society and even family members are not uncommon.
The REActors of the EECA region make every effort to constantly monitor and address situations where there is a violation of the rights of sex workers and workers. Today we bring to your attention several publications with an overview of the situations in Moldova, Tajikistan, and Georgia, as well as the support and struggle of paralegals against discrimination against this key group in these countries.
Today and always it is worth remembering that sex work is an activity like any other, which requires acceptance and respect. And its representative – respect for the rights and non-discrimination to himself/herself and his/her choice.
Also read:
The right to a decent and fulfilling life: the world celebrates Zero Discrimination Day
Moldova provides for administrative liability for engaging in sex work. The article is often applied, and in 2023 there will be a tougher punishment by increasing fines. And while this discrimination and stigmatization of sex workers breed violence, increase the vulnerability of this key group, puts their health at risk, and limits access to justice, girls, and women are willing to take risks to feed their families and survive. Many official salaries are not even enough to pay for the simplest services, so there are more and more sex workers in the country, and law enforcement officials use this article as a means of extortion, control, and punishment of those who refused to pay off.
According to one of Moldova’s national REActors, it is common for a beneficiary to be fined for a different reason, which is much higher than the penalty for sex work. For example, there was a case when a girl was fined, but another administrative violation as indicated in the protocol, since they could not prove that the beneficiary was a sex worker. Therefore, an attack and a conflict with the police were indicated. Sometimes services are not paid for, and if a girl is caught, she will have no reason to close the fine. In this connection, sex workers often try to run away or negotiate “on the spot” with the police. Persecution and violence against girls by law enforcement agencies occur on an ongoing basis, they are discriminated against and humiliated, and they can be beaten, but they refuse to write complaints, knowing that they are being prosecuted by law. And if they are consulted, then only anonymously, as they are afraid of publicity.
The presence of such fines often becomes an excellent reason for discrimination on the part of other employers: a person can be fired without benefits and explanations, or denied pay. However, if it comes to REActors, then the probability of a positive solution to the situation increases significantly. So, in one case, a former sex worker got a job caring for a disabled person. After working for 4 months, she came for a salary, but she was refused – the employer referred to the fact that she had previously provided sex services, but did not mention or warn about this when she was hired. The client turned to REActor, who promptly got in touch with him and threatened to file a complaint. A week later, the due funds were paid to the girl in full.
Even children of sex workers are discriminated against. They are teased on the streets, and sometimes in kindergartens. The REActor recorded a case when the educators asked the mother, a sex worker, to transfer the child to another preschool institution. After the paralegal learned about the situation, a consultation was held with the beneficiary, and a conversation was held with the educator and director of the kindergarten. As a result, the child was simply transferred to another group and the kindergarten did not have to be changed.
The reality is clear: Moldovan legislation regarding key populations remains repressive and discriminatory. But we must remember that for the situation to change, we need to start from the very “top”: the government should abandon the application of laws on administrative violations that punish sex work. It is necessary to stop harassment and violence against representatives of the sex industry by law enforcement agencies and allow everyone to work in safety and inadequate, equal conditions.
In recent years, Georgia has made significant progress in combating violence against women and domestic violence, especially in terms of criminal prosecution of such crimes, as well as the improvement of victim protection and assistance mechanisms. In 2017, Georgia ratified the Council of Europe Convention on the Prevention and Suppression of Violence against Women and Domestic Violence (Istanbul Convention)and took measures to bring Georgia’s legislation into line with the Convention. Currently, the legislation defines various forms of violence against women and provides important mechanisms for responding to violence.
Despite positive changes, women belonging to vulnerable groups face special barriers in accessing justice for sexual violence. Barriers, in many cases, are caused by inappropriate or discriminatory legal regulation, stigma against vulnerable women, and inadequate preparation of judicial bodies in criminal prosecutions to the specifics of vulnerable groups. Since women representing the mentioned groups face special barriers in terms of using legal means and practice on these issues is extremely rare, and it is impossible to obtain important information about their specific problems. REAct is the only possibility in terms of identifying their problems and needs. Despite the existing problems, in most cases, the police react positively to the violence against sex workers, as evidenced by the cases registered in the REAct system.
Tamta (name changed), sex worker, 33 years old
The beneficiary is a sex worker, 33, who was married and divorced due to abuse, was systematically subjected to psychological and physical abuse by her husband, mainly due to jealousy and an alleged association with sex work. After one of the incidents, she turned to the patrol for help with the children. They were given the status of victims and placed in a shelter.
Lika (name changed), sex worker, 31 years old
The commercial sex worker provided service to the client, but upon arrival demanded to establish an unspecified and unacceptable relationship for her, after which she verbally abused her, then proceeded to physical violence. However, with the help of a friend, the beneficiary managed to contact the police, and the offender was arrested.
According to the current situation in Georgia, the police react immediately and strictly against violence against women, based on the existing legislation, including violations of the rights of women sex workers.
Kakha Kvashilava, REAct National Coordinator: “In our practice, it has never happened that the police refuse to initiate an investigation or do not respond because the victim is a sex worker. The attitude towards violence in the country is as strict as possible, therefore the attitude of the police towards the victim from this key group is the same as in any other case: adequate and within the framework of the powers granted by law. That is why affected sex workers have recently turned to the police more and more often, and their confidence has increased to a certain extent. This is facilitated by the fact that to combat violence against women, national mechanisms and institutions have been created that are developing positively, legal norms are being improved, public awareness is being raised, and the office of the public defender is actively working. The state mechanism against violence exists at a high level of the hierarchy – the government. And criminal, civil, and administrative mechanisms are used to detect and prevent violence against women and/or domestic violence.
Therefore, if necessary, it is enough for the victim to call 112 and report the incident, which will be followed by an immediate response from law enforcement agencies.”
The REAct team hopes that the current situation will improve further and that other vulnerable groups’ rights violations will be dealt with fairly and immediately.
On November 9, 2018, the United Nations Committee on the Elimination of Discrimination Against Women (CEDOW) issued recommendations to Tajikistan, noting that contrary to the Committee’s proposal to abolish punishment for sex work, reports of intimidation, harassment, and violation of the rights of sex workers have increased. These women are being repressed for their work because of the “undermining of traditional values”. Moreover, administrative responsibility for this activity was also toughened (fines increased or arrests up to 15 days) as a necessity for the “fight against prostitution” and against the spread of HIV.
Society does not want to open its eyes to the fact that this is nothing more than a stereotype – according to the National Program to Combat the HIV Epidemic for 2017-2020 HIV prevalence among female sex workers was only 3.5%! And the main route of transmission of the virus in the country is heterosexual sexual intercourse (in some regions, the proportion of such cases has reached 70%). But for most law enforcement officials, medical center employees, and even acquaintances and relatives, sex work is a stigma and an evil that brings problems, and it should be punished. And the methods chosen for this, at times, turn out to be far beyond the legal field.
However, even given such unfavorable conditions, REActors in Tajikistan manage not only to record the facts of violations but also successfully help sex workers overcome the problems that have arisen and assert their rights.
“We all know about you!”
In January, one of the REActors received a call from Aziza (name changed). The girl was previously a sex worker, but at the time of the conversation she no longer provided services, lived in a hostel with a small child, and earned money by cleaning houses. One evening, two police officers came to them and asked the watchman to call Aziza. When the client asked what they needed, law enforcement officials began to intimidate the girl, saying that they knew about her positive HIV status and what she had been doing before. Further, blackmail began – either publicity or work for them and revealing the names of other sex workers. Aziza said that she had not provided sex services for a long time and could not know anyone. Then the police began to interrogate where and from whom she got infected, and who was her former clients. The client said she did not know this and was not going to talk to anyone. In response, threats followed, up to the initiation of a case for prostitution and deprivation of child custody. Not surprisingly, the next day, the girl took her daughter and ran away from the hostel. Having recorded everything, the REActor asked for the telephone number of the policemen who had come and called them. Introducing himself, he explained that he could follow their similar actions. Initially, they behaved aggressively, also threatening to be held accountable for aiding and concealing data. But when the paralegal said that they, too, had justice through complaints and statements to the Prosecutor and the police chief, they asked for a meeting. Then there were threats again, but the REActor insisted on his own. Hearing this, the self-defense method worked for the employees of the authorities, and they offered to call Aziza to meet all together and discuss further actions. On the spot, the client and the policemen gave their word that they would no longer interfere in her life and would not disturb the girl.
“I want to be with you so much…”
The REActors hotline received a call from Gesu (name changed). The girl asked for help – she was publicly beaten for being engaged in commercial sex. In a personal meeting, the client said that she had recently been with a young man. He liked her, and the guy offered to be with him all the time but was refused. Repeated attempts to again attract the girl to intimacy also turned out to be fruitless. One day the guy saw Gesa with another young man. After that, choosing the moment when she was returning home from her friend alone, he, along with a friend, blocked the path and the men began to pester her. The client asked to be released and tried to run away, but they started beating her. A woman was walking nearby, saw this, and called her neighbor, a district police officer in another territory. Upon arrival, the policeman smelled alcohol, began to separate them, but blamed Gesa for everything! Instead of detaining the rapists and fixing the violation, a law enforcement representative reproached that she had already been caught by the police once. Then he asked everyone to disperse and warned the girl that if this happens again, he will take her to the department.
The girl left in tears and beating. And then her call to the REAct hotline sounded. The paralegal immediately offered Gesа his help, contact the forensic examination and remove traces of beatings. He agreed. Together they underwent an examination in a forensic medical examination, took a conclusion, and then went to the police station and wrote a statement. He was registered, and at the same time, the client gave testimonies against the district police officer, who ignored the fact of the offense. The next day, Gesa was summoned to the police department. They drew up a protocol and opened a criminal case against the rapists. And the situation with the district police officer was taken under control by those responsible for the internal investigation.
Said, REActor, Tajikistan: “By proving the correctness of clients and the wrongdoings by the police, you become an experienced and authoritative defender of the rights of key groups. But you must remember that you need to speak with representatives of the authorities in the language of substantiated facts, then you can agree. The REActor must understand the differences between offenses and ordinary cases – I will not hide that each policeman, before starting a substantive conversation, first assesses the level of my knowledge. But for myself, I made a rule: once you start to defend, then fight to the end. Otherwise, you will lose both trust and authority.”
Sex work is an activity like any other that requires acceptance and respect. And its representative – respect for the rights and non-discrimination to himself/herself and his/her choice.
“Discrimination is a violation of human rights and must not go unchallenged. Everyone has the right to live with respect and dignity.” – 8th UN Secretary-General Ban Ki-moon
Zero Discrimination Day, or Anti-Discrimination Day, has been celebrated on March 1 since 2014. It was initiated by UNAIDS (UNAIDS), the Joint United Nations Program on HIV/AIDS. On this day, every year around the world, civil society and states, officials, activists, journalists, and donors, again and again, support the elimination of infringement of human rights, including against key groups.
The UN notes that the consequences of inequality are experienced by 70 percent of the entire population of the world and this is a significant obstacle to the development of society as a whole. And the most tangible blow is felt by the most vulnerable segments of the population. Thus, according to UNAIDS statistics, the 90-90-90 treatment cascade in the region of Eastern Europe and Central Asia is still far from being achieved. In 2020, it was 70-44-41 and one of the key reasons for this situation is that social and legal conditions still require significant changes and improvements. In many countries in the region, laws are discriminatory—they deny human rights and fundamental freedoms and result in people being treated unequally, excluded from basic services, or subjected to unreasonable restrictions, simply because of who they are and what they do.
REAct, as a tool for monitoring and responding to human rights violations, sees the solution to the situation as improving the legal environment, providing access to services for key groups, and removing discriminatory barriers from government agencies and society. And these changes are already taking place:
Moldova, 2021. The patient fought for his right to access HIV prevention and treatment services through the electronic REAct system. Together with the coordinating team of the National HIV Program and partnership organizations with the Chief Narcologist of Moldova there was set up the opening of a substitution therapy point in Orhei city.
Tajikistan, 2022. REActors and representatives of state structures jointly changed the picture of constant violations of human rights in the regional AIDS Centers. The situation was extremely difficult: on the part of the medical staff, 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.
Georgia, 2021. The sex worker decided not to be silent and fight for her rights – her husband found out about her work and as a result, the woman was subjected to physical violence. With the help of the REActor, the case was resolved positively, the offender was punished, and the client with the children is now safe.
These are just a few stories. But on their example, we want to say today – it is possible and necessary to comprehensively influence the change in the legal environment to eradicate discrimination. Both from the side of another person, and the whole country as a whole. And thanks to the existing REAct tool and the difficult but effective work of partners and paralegals in the region, this transformation is already happening and making its contribution to the EECA region.
February, 17, the coordinative meeting of national REActors and partner organizations representatives who are involved in the program was held in Tbilisi. The key point of the meeting became approving the one-year work plan, as well as getting introduced to the changes and challenges for 2023.
This year REAct in Georgia will continue to collect, and monitor cases about human rights violations and create reports based on the date. The national Team is going to initiate implementation of the drug policy advocacy plan and will try to mobilize interested partners and recourses to start the process. As a result, REAct will continue to have legal consultation service in 2023, and under the program will be conducted sensitization training for the Medical staff, based on the needs visualized in the previous reports.
«REAct is a unique system for measuring the situation of human rights in a country, that has no analogs, and the sustainability of its functioning is essential.» – said Mr. Kakha Kvashilava, REAct National Coordinator. «It continues to operate in Georgia until the end of 2023, after a short break, which is very important to note, by the support of National Center for Disease Control and Public Health, under Global fund project”.
REAct team already conducted in February one coordinative meeting, also one training on human rights violations and about the system updated – new field that was just added into the system (regarding the identification of the rights), and one training for new REActors to get accuanted with the online platform, as some organizations, changed their representatives and also for the national organizations that just started the partnership with the tool.
REAct Georgian Team hopes for the continued sustainability of the REAct system in Georgia and to have possibility to implement all the needed activities responding identified needs in country, that were not included in this year’s plan to increase the efficiency of the outcomes and actually change the human rights situation in the country.
February 3-5, 2023, a training was held in Yerevan on documenting cases of violation of the rights of representatives of key populations, as a measure to counteract obstacles in the provision of HIV services. REActors of three national, public organizations of Armenia that are implementing the project in the country were invited to participate: New Generation, National Trans Coalition, and Eurasian Key Populations Coalition. The trainer of the event was Victoria Kalyniuk, Regional Coordinator of REAct.
Over the course of three days, the REActors had the opportunity not only to learn more about the work of the tool itself but were also involved in practical exercises on the definition of discrimination, the level of stigmatization, the analysis of the legal environment of the country and the study of the obligations of the state in protecting the rights of key groups.
“A significant part of the event was devoted to the practice of interviewing, to correctly document by REActors, first of all, sensitive topics. For example, about violence,” Victoria shares. “I also want to note that this training is different from the previous ones, as for the first time it presents a lecture on gender-based violence, its fixation, causes, and consequences. We have not done this before. I think this will be a good start for a series of similar professional training for REActors and other countries in the region where our project is being implemented.”
On December 23, in Tashkent, the Republican non-governmental non-profit organization “ISHONCH VA HAYOT” organized an event aimed at the dialogue of civil society and government agencies on solutions to reduce barriers related to human rights violations among people living with HIV and vulnerable groups with increased risk for HIV infection.
On the part of departmental structures, representatives of the Republican AIDS Center, the Ministry of Health of the Republic of Uzbekistan, the Secretariat of the CCM, the Ministry of Internal Affairs of the Republic of Uzbekistan, the Ombudsman, the Ministry of Employment and Labor Relations of the Republic of Uzbekistan, the International Organization for Migration (IOM) in Uzbekistan, USAID, UNAIDS, as well as Civil Society Organizations and representatives of the PLHIV and KP community.
Particular attention at the round table was focused on the presentation of the work of “ISHONCH VA HAYOT” on documenting cases of human rights violations and responding to them, within the framework of the project “Reducing barriers related to human rights violations among people living with HIV and vulnerable groups of the population with increased risk of HIV infection and increased remote legal support for women who have been subjected to violence” (REAct).
“The collected data is not for accusations. We are only stating the fact that, alas, there are violations and we need to look for ways to solve them together to avoid such problems in the future.” – says Sergey Uchaev, Chairman of the Board of “ISHONCH VA HAYOT”. “I am sincerely glad that our research within the framework of the REAct tool has caused an adequate response from participants from government agencies – after all, the vast majority of violations are recorded precisely from their representatives. There was no denial, on the contrary, the understanding that there are gaps in these issues since not everyone has an understanding of how to work with key groups. For example, the Ministry of Internal Affairs of Uzbekistan has only recently created a department for working with the community of PLHIV – there are new employees, and they have a great interest both in prevention programs and in the field of patients’ rights. But knowledge is still lacking. Therefore, we agreed that for further, successful work, a constructive dialogue between civil society and government agencies is necessary. And for our part, we will support him in every possible way.”
As a summing up of the round table, the participants adopted the key conclusions and recommendations based on the results of the annual report within the framework of the project “Reducing barriers related to the violation of human rights among people living with HIV and vulnerable groups of the population with an increased risk of HIV infection and increasing remote legal Support among Women Subjected to Violence” (REAct) to change the situation with the rights of key populations in Uzbekistan:
– Bring the norms of criminal legislation in line with the requirements of international human rights treaties. In particular, to consider the issue of the complete abolition of Art. 113 of the Criminal Code of the Republic of Uzbekistan.
– Bring the norms of criminal legislation in line with the requirements of international treaties on combating drug trafficking. In particular, consider creating an effective system of alternatives to punishment for crimes not related to the commercial sale of drugs, including the creation of a system for voluntary referral of people who use drugs to treatment and prevention services. To give clarifications to the Supreme Court of the Republic of Uzbekistan on the restrictive application of penalties to people who have committed acts not related to commercial sales.
– Consider the question of the complete abolition of Art. 190 of the Code of Administrative Offenses of the Republic of Uzbekistan (engagement in prostitution) and on the limited application of the norms of the Criminal Code relating to sex work (Articles 130, 131 of the Criminal Code of the Republic of Uzbekistan) only to cases of exploitation of prostitution and guided by the principle of non-punishment of the victim.
– Conduct mandatory information events with the participation of civil society organizations for employees of government agencies and medical institutions that interact with PLWH and representatives of other CGs, to constantly inform on issues about HIV infection, including clarification of points of scientific consensus regarding the possibility of transmission of HIV infection in those or other circumstances (use of a condom, ART, etc.), as well as clarification of the provisions of the Criminal Code of the Republic of Uzbekistan regarding the form of intent for crimes that are considered completed from the moment the acts were committed, regardless of the onset of consequences (Article 21 of the Criminal Code of the Republic of Uzbekistan), and the provisions Criminal Code of the Republic of Uzbekistan on the public danger of an act (Article 14 of the Criminal Code of the Republic of Uzbekistan).
– Conduct consultations with health authorities to ensure that registration does not affect the ability to receive health care services citizens. – Conduct regular information and training activities with police officers, lawyers, and judges on the work within the framework of the implementation of the Palermo Protocol including the need to follow a rights-based human principle is not punishment of the victim, which primarily includes the creation of conditions for the protection of the rights and exclusion of punishment for sex workers to effectively combat human trafficking, based on the recommendations of the United Nations Coordinating Group on Combating Trafficking in Persons.
Recall, as of the end of 2022, 13 REActors of Uzbekistan recorded 797 complaints about violation of the rights of representatives of key groups since the start of the pilot project in 2020.
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.
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.
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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.
