Response stories

Violation of patient’s rights: the story of an arrest in an Armenian hospital

Yegan (name changed) wrote to the National REActor about a disturbing situation that happened to his friend. The guy went to the Republican Hospital to take tests before his nose surgery. He is from a community of people who inject drugs (PWID) and while drawing blood, the nurse noticed a blackened vein on his arm. She immediately asked if he was using drugs and the guy, trusting the health worker, answered in the affirmative.

While the blood results were still pending, the patient was sitting in the hallway. Suddenly he was approached by two police officers who, twisting his arms, took him to the station. It turned out that a nurse had called the police and informed them that a man from the PWID community was in the hospital. Yegan said his friend had been arrested and for over ten days at the time of contacting REActors, no information on his condition and whereabouts had been given to him. The case has been accepted for work.

This story highlights the serious violations of patient rights and the unacceptable disclosure of personal medical information. That a nurse felt able to call the police based on a patient’s medical information is a blatant example of ethical and confidentiality violations. Trust in medical personnel is the basis for receiving quality care, and cases like this undermine that trust.

Egan’s friend’s situation also points to the need for reform in the way people who use drugs are treated. Instead of prosecution and arrest, they should be offered medical care and support. Violation of patients’ rights and undue interference of law enforcement agencies in medical issues require attention and solution at the state level.

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Response stories

An assistance with recovery through OST in Azerbaijan

The situation happened to Elmira (name changed), a 25-year-old woman from a community of people who use drugs. Her life circumstances were such that she started with light substances, but soon moved on to heavier ones, and this led to addiction. A turning point in her life was the tragic death of her lover from an overdose – this made Elmira decide to stop using. Elmira turned to a REActor. Understanding her desire to quit drugs and change her situation, he helped her access opioid substitution therapy (OST) at the Republican Narcology Center (RNC). With REActor’s support, Elmira began her treatment journey.

The initial stages of treatment were incredibly challenging for Elmira. However, with perseverance and the support of the medical professionals at RNC, she managed to stabilize her condition. Her commitment to the program and the structured support it provided were crucial in helping her navigate the difficulties of withdrawal and recovery.

Today, Elmira stands on the threshold of a better life. She has found employment and has mended her relationship with her parents, rebuilding the connections that had frayed during her years of addiction. Elmira’s journey to recovery highlights the profound impact of access to effective treatment and support systems. Her story is a beacon of hope for others struggling with similar challenges, demonstrating that with the right help, it is possible to overcome addiction. Her story is a powerful testament to the transformative impact of OST and the comprehensive support offered by REActor and the NGO Struggle Against AIDS (SAAPU).

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News Response stories

Entitlement or preference? The world celebrates Health Day

April 7 marks World Health Day, founded by the World Health Organization (WHO) in 1950. This day recalls the importance of health for all people in the world and emphasizes the need for access to skilled health care as a fundamental human right. In this context, providing life-saving services such as opioid substitution therapy (OST) to people from key populations is critical. This approach enables patients to manage physical dependence, reduce the risk of transmission of infectious diseases (e.g. HIV or hepatitis), and improve quality of life.

However, despite the proven effectiveness of OST, many people around the world (including in the Eastern Europe and Central Asia region) face barriers to accessing this treatment due to stigmatization, lack of access to health services, or legal restrictions. This creates serious obstacles for those in need of assistance.

For example, recent changes to the Ministry of Health’s January 24 Order to the opioid substitution therapy program in Georgia have made significant adjustments. Under the previous rules, patients participating in the program had the opportunity to receive a two-day dose of medication if they were unable to visit a healthcare facility, and this dose could be picked up for them by a family member or other authorized person. However, under the changes made, this right has been limited and patients or their authorized representatives must now visit the service center daily.

The changes also affected the ability to provide patients with pharmaceuticals in special cases. Previously, there was an option to receive a five-day supply of medication when long-term home treatment exceeding two months was required, or a seven-day supply for those with a pronounced disability or active tuberculosis. However, the amendments have completely abolished this exceptional regulation. Under the previous regulation, patients could also be given a dose if they had to move around the country (the principle of business travel). The innovations have abolished this regulation and now, even in cases of exceptional need such as business travel or ill health, patients can only be given a one-day dose.

Kazakhstan also has a serious problem with violations of the rights to health care and health maintenance for people who use psychoactive substances. These problems have been identified, including through the REAct, on appeals related to obstacles in accessing medical services for clients. This situation covers several aspects:

– Lack of access to free medical care, including tests and abortions, for persons without compulsory social health insurance.

– Limited access to a guaranteed amount of free medical care for people who use psychoactive substances.

– Insufficient drug supply and diagnosis of diseases among persons in detention centers.

According to the Order of the Minister of Health of the Republic of Kazakhstan from September 23, 2020, № KR DSM-108/2020, treatment of people who use psychoactive substances is carried out within the guaranteed volume of free medical care in regional Mental Health Centers (MHC). Anonymous treatment is available only on a paid basis. However free medical care does not provide the necessary range of services for social, psychological, pedagogical, labor, cultural, economic, and legal support for people from the community.

The theme of this year’s World Health Day is “My Health, My Right” and aims to support and recognize the right of everyone, wherever they are, to access high-quality health care, education and health information, and freedom from discrimination. This means that it is worth taking another opportunity to draw public attention to such violations of people’s rights to quality and timely health care and the need to develop a model that complies with human rights principles and international standards while taking into account the needs of patients, their families and the interests of organizations providing addiction treatment services. And legislate to guarantee the provision of a full range of assistance for the treatment and rehabilitation of everyone who needs it. 

Health is everyone’s right, as is equal access for all people to qualified care.

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Brochures Journals News Useful materials

REAct cases are included in Matrix for analysing trends in human rights violations against people who use drugs

Partners' publication

In December 2022, the Eurasian Harm Reduction Association (EHRA) published Matrix 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.

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Response stories

Montenegro: Wind of change in healthcare system that brings unexpected moments to the key groups

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.

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Response stories

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

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)

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