Categories
Response stories

Client Incident: Wrongful Disclosure of Medical Information in Uzbekistan

Confidentiality of medical information is a fundamental principle in health care. Physicians and medical staff have to protect patient confidentiality and prevent the disclosure of personal information. In this article, we will examine one case involving a client who experienced the wrongful disclosure of his medical status to his neighbors.


Case Description:


In this incident, the client lives with his wife in an apartment that is located in the same building as his parents. While they were away on vacation that same day in the evening, a neighbor who lives on the ground floor came and informed the client that they had been visited by the polyclinic for an annual medical examination because they were allegedly registered at an AIDS center. The shocked client and his wife immediately visited the central polyclinic of Yangi-Khaet district to find out the reason for such visits and the disclosure of their medical status to their neighbors. However, the nurse they contacted stated that she had not visited them and had not disclosed the information to the neighbors. Because of this misunderstanding, the client and his wife appealed to the management of the outpatient clinic to stop further disclosure of confidential information.


Solution:
To resolve the incident, the client and his wife decided to contact their neighbors and find out who exactly had visited them in their absence. It turned out to be a nurse working with a general practitioner. After speaking with the nurse, the client and his spouse discussed the disclosure of medical status and possible consequences for the offender. The nurse promised that this situation would not happen again in the future. The nurse then went to the neighbors and explained that a mistake had been made and apologized for the inappropriate disclosure of confidential information.


Conclusion:


The described case is a serious violation of the principles of confidentiality of medical information. Disclosure of medical status without the patient’s consent is unacceptable and can lead to negative consequences for the patient, including violation of their rights and trouble in the community. In this case, the client and his spouse were able to resolve the issue by having an explanatory conversation with the nurse and neighbors. However, incidents such as these emphasize the importance of respecting the principles of medical confidentiality and the need to take appropriate measures to prevent similar breaches in the future.

Original Source (in Russian)


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REAct in Uzbekistan: Overcoming Barriers and Promoting Quality Health Interventions based on Human Rights

At the end of May, a two-day training on the REAct tool was held in Tashkent, Uzbekistan. The main objective of this event was to enhance the knowledge and skills of participants in overcoming barriers to access to health services for key populations and promoting quality health interventions based on human rights principles.

The first day of the training was dedicated to the basics of using the REAct tool. The participants received extensive information about the system and its practical application. The session discussed issues and problems arising in documenting and recording cases of human rights violations. The trainer shared his experience, reviewed typical mistakes, and provided recommendations on how to correctly fill out forms and provide reliable information on human rights violations.

The second day of the training started with a session on mechanisms for responding to human rights violations after documenting cases. Participants received information on the next steps, including interaction with law enforcement agencies, state institutions, and non-governmental organizations. The trainer emphasized the importance of following legal procedures and provided participants with information on available resources and support mechanisms.

As a result of the two-day training, participants learned new skills and tools that will help them to work more effectively with the REAct system and improve access to health services for key populations. The exchange of experience and discussion of practical situations made this training a valuable and interactive experience for all those present.

This event in Tashkent emphasizes the importance of respecting human rights and legal procedures in providing health services and responding to human rights violations in Uzbekistan.


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Survival Story: How an organization helped a woman overcome her HIV diagnosis and start a new life

Article about how ISHONCH VA HAYOT helped a homeless woman suffering from HIV to start a new life, accept her diagnosis, and become self-sufficient through support, counseling, and material aid.

The client’s life situation was strikingly tragic. Two years ago, she knew of her HIV diagnosis and did not accept it. The woman was at a loss and did not know how to go on. Her mood was low because of the unpleasant situation with her partner. It seemed that life had ceased to have any meaning and she was ready to give up on therapy.

ISHONCH VA HAYOT approached this case with the utmost care, understanding that her primary concern was to help her client to accept her diagnosis and learn to live a full life. They made contact with the client and tried to convey truthful information about living with HIV and discuss her moods and her past.

The woman talked about her difficult childhood, in which her parents constantly consumed alcohol. She also shared how her father’s friend almost raped her when she was young. The orphanage was no better, but the client was fed, slept in a soft bed, and was not beaten or molested. The client tried to do well in school, and eventually, she met a guy who took her into his family, where they had children.

When the woman contacted to ISHONCH VA HAYOT, she was homeless – evicted from the room she shared with her roommate. The organization did everything possible to help her: helped to get a room in the dormitory and dealt with her benefits. They found her a job and helped her start her business selling cakes at the clinic. They also provided financial assistance and legal advice on how to proceed.

The client was able to recover and start a new life. She began taking therapy and understood the importance of continuing it. The woman started attending group classes for people with HIV where she found support and understanding, exercised regularly, and takes care of her health. In addition, she is actively running her own business and has a steady income.

ISHONCH VA HAYOT continues to support her client and help her to live a full life. She was helped to get a subsidy to repair the home she bought herself and to arrange a wedding with her partner.

Currently, the client continues to live an active lifestyle and lives happily with her family. She proved to be a strong and resilient woman who coped with her challenges and succeeded in life. The organization is proud to have helped her through a difficult time and become happy and successful.

Original Source (in Russian)


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Uzbekistan hosted a round table on the topic of reducing barriers related to the violation of the rights of key populations

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.


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Categories
Response stories

Illegal Detention: Rescue a Victim Immediately

Illegal is the detention committed in the absence of the listed grounds for its application or in violation of the procedural order (for example, without drawing up a protocol of detention). The corpus delicti is formal. The crime is considered completed from the moment of illegal detention.

Competent persons and citizens for their illegal or unjustified detention or abuse of authority during detention are subject to liability established by law. According to Article 234 of the Criminal Code of Uzbekistan, knowingly illegal detention can be punished with imprisonment of up to 1 year.

The clients of the REActors were detained in the evening in Tashkent, in the park of Babur. They walked, and later sat down on a bench. After some time, a representative of the Milliy Guard (the National Guard of the country) approached them and said that he had been watching them for a long time and, in his opinion, they were behaving very suspiciously. After that, he called three more employees of this unit. Then the clients began to be interrogated, threatened with insulting words that there are cameras everywhere and they recorded everything. That now the police will be called and the detainees will be handed over to them. The clients didn’t mind. Representatives of the internal organs arrived, they were taken to the district office. There, two representatives of the police organized an interrogation, photographed and fingerprinted, and released them three hours later.

Clients were consulted on human rights. They do not mind making a statement if law enforcement officers start calling them again on this issue. At the moment, contact with them is maintained.

Original Source (in Russian)


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Denial of access to ART while under arrest

In addition to interrupting therapy, the resumption of treatment also poses a threat to human health, as resistance (virus resistance) to treatment can develop in the body. It can also lead to side effects and psychological complications.

During the client’s treatment at the Specialized Infectious Diseases Hospital, namely consultations about his adherence, a problem was identified. The low adherence of a person was caused by the fact that law enforcement officials deprived him of the right to take ART for the period of his detention for 15 days. These cases were repeated more than once, which over time caused a deterioration in health and an increase in viral load.

The reason for the client’s arrest was his own sister, with whom they live in their parent’s apartment, conflicts occur between them with corresponding consequences.

The person received counseling on the treatment of HIV, the concomitant disease of hepatitis C, as well as on the rights of PLHIV, their assertion and obtaining disability due to illness. Then he was redirected to consult a lawyer to resolve legal issues and solve life situations.

Original Source (in Russian)


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Insults and humiliation due to sexual orientation

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)


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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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Denial of treatment due to HIV status

In situations of refusal of medical care, be sure to ask for a written document with the conclusion (refusal) of the doctor, head of the department based on the results of the appeal. Further, you should immediately contact the head physician in order to minimize the time for a possible solution to the problem. You need to try to document all actions in a medical institution, so that later there will be evidence to defend your rights in higher authorities.

During the course of treatment in a specialized infectious diseases hospital, the client told the REACtor about his problem. He said that in addition to HIV, he has an incurable disease called lupus, which must be treated so that there are no complications. At his place of residence, he took the necessary documents and went to Tashkent, to the dermatovenerological hospital. There, during registration, they found out that he had HIV infection and refused, referring to the fact that they did not have a place and that he needed to be treated elsewhere, at his place of residence in the region.

During the consultation with the REACtor, the client received the necessary information on the issues of HIV treatment and prevention, as well as on the rights of PLHIV, and was further referred for consultation with a lawyer in order to investigate this case. He went to the hospital again, with a referral, already informed by the lawyer how to defend his rights. And as soon as they wanted to refuse again, he began to do it. The client informed that in case of repeated refusal of treatment, he would apply directly to the Ministry of Health with already prepared complaint documents. The medical staff got scared, and the client was put on treatment in turn.

Original Source (in Russian)


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Transmission of HIV through blood transfusion

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Response stories

Transmission of HIV through blood transfusion

Infection with HIV infection through the blood (parenteral route of transmission) occurs when infected blood enters the body – directly into the bloodstream, skin damage and mucous membranes, in contact with blood and other fluids, tissues and organs of the body.

The client turned to REACtor during her treatment in a specialized infectious diseases hospital. She said that in December was a car accident, where she received injuries that require surgery and a blood transfusion. After treatment and rehabilitation, the woman was discharged home. Six months later, her health began to deteriorate. The client went to the doctors, underwent medical examinations, but they did not give results. Then she was offered to take a blood test for HIV and as a result the test was positive. The woman was in shock – she is a married woman, has children, had no other relationship. When interviewed by an epidemiologist about whether she had any medical manipulations or operations, the client replied that she had an accident and received a blood transfusion. After that, the woman was registered and began her treatment.

The client received the necessary advice regarding her health and HIV treatment, further on the rights of PLHIV, consulted a psychologist and was referred to a lawyer. The lawyer, having studied the whole situation, offered to help draw up an application and file a lawsuit against the hospital in which the operation was made. But alas, the client refused, because she did not want anyone else to know about her HIV status and this would bring problems to her family and loved ones.

Original Source (in Russian)


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Nurse disclosed client’s status

Disclosure of medical confidentiality is the disclosure of such information to at least one person (with the exception of the patient himself, his legal representatives or the medical staff involved in the treatment of this patient). It does not matter who they became known to: a friend, a colleague of the victim, or strangers.

While undergoing treatment in a specialized infectious diseases hospital, a client turned to the REACtor. During counseling, he told his story. Being at his place of residence, one day a patronage nurse asked him where the person lives and named the client’s full name. The man did not show that he knew who it was and that he lived there. Then he asked why the nurse was looking for a person. The woman replied that he hasAIDS and he needed to urgently come to the district clinic for a medical examination and a note from an infectious disease doctor.

After the client was consulted at the REActor on the prevention and treatment of HIV, as well as on the rights of PLHIV, in order to further resolve the problem of disclosing his status, he was referred to a lawyer for advice and step-by-step actions. Upon returning home, he turned to the head physician of the district clinic about the situation that had happened to him and this nurse. The head doctor asked for forgiveness for his employee, and the nurse herself repented and apologized for her misconduct. Since other outsiders were not witnesses to this event, the client forgave her, but with a warning that if such an action is repeated, he will demand proceedings and go to court.

Original Source (in Russian)


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