Society
Meeting the mothers with HIV who refuse doctors’ recommendations to abort their babies in Ukraine and Moldova
I meet Svetlana in a cafe in central Kyiv. She is 38 years old and a month away from giving birth to her first child.
“Finding I was pregnant was very sudden,” she says.
A sales consultant in a clothing shop, from 1994 until a few months ago, she injected a Ukrainian form of heroin, shirka, which she made in her kitchen or bought in syringes from dealers.
Four times a day, she used the mixture of home-grown poppies and chemicals, including at work. Her husband, an electrician, was also an addict.
After she discovered she was pregnant, she took an HIV test, which revealed she was positive for the virus.
She pauses and leans back.
“I thought my life had stopped,” she says, dragging her fingernails across her arm, to simulate slashing her wrists.
When she consulted a female gynecologist in a local hospital for a check-up, the reaction of the doctor – who knew Svetlana’s history – was immediate:
“You should abort the child,” she said.
But after searching for more information on the rights of drug users, she gained help from staff at a local organization, Convictus, who informed her that she could give birth. And Ukraine’s medical system had to support her decision.
She and her husband stopped injecting and switched to a substitute for heroin – methadone – prescribed by medics.
“I don’t want to go back to shirka,” says Svetlana. “Now I have a new family. I have an idea for life.”
Svetlana plans to call the child Bogdana – which means ‘given from God’.
Recommendations to drug users with HIV to abort children are common among medical professionals in eastern Europe.
“The feeling is the children will be born crazy, dead or sick,” says Iulia Dorohova, a legal advisor at Kyiv-based NGO helping people living with HIV, Vertical.
“Women have to be quite strong to stand up to doctors,” I say, “especially when they are pregnant.”
Dorohova shrugs, dismissing my point.
“Ukrainian women are tough,” she says. “They can stop a horse.”
“Doctors are afraid”
Under the UN Declaration of Human Rights no one can face discrimination regarding his or her health status.
Because drug addiction is classified as a health condition, users should receive the same treatment as others.
The same declaration states that every person has a right to a family. Therefore coercing women into abortion is an infringement of customary international law.
However in the medical systems in many countries in east Europe, the poor suffer because they can’t pay bribes to doctors and nurses for care which should be free at the point of access.
Drug addicts suffer because health workers believe they have created their own problems.
HIV carriers suffer because medical staff are afraid of catching the virus, due to a lack of understanding of its behavior.
Women from these demographics face even further prejudice because there is a prevailing assumption that a woman should be more responsible for her well-being than a man.
“In the medical system, HIV cases and drug addicts often have to stay in the queue,” says Ala Iatco, deputy at ‘Youth with the Right to Live’ organization, Moldova. “For women there is more stigma.”
It is rare that doctors force women into abortions, but suggestions for termination seem to be a common in Moldova, Ukraine, Belarus and Russia.
“In east Europe women who use drugs, especially those with HIV, often face discrimination during and after their pregnancy,” says Olga Byelyayeva, technical support and information program officer at Eurasian Harm Reduction Network. “In Ukraine, for instance, this problem is rooted in the legislation – according to the pregnancy protocol, drug users are being officially recommended to have an abortion.”
In Balti, Moldova, HIV carrier Maria already had a healthy daughter when she was three months’ pregnant with a child suspected of having Down’s Syndrome.
“The doctors told me to have an abortion,” says the 35 year-old. “A commission of medics convinced me I would give birth to a monster child. They told me: ‘why do you want to condemn the baby?’ But I gave birth to a perfectly healthy child.”
Moldovan Human rights group IDOM’s head of litigation Natalia Mardari says the key is changing the mentality of medical staff to respect the rights of people with HIV.
Many doctors and nurses fear touching with people with HIV. In orthopedic surgery, doctors often refuse care to HIV patients, because interventions require heavy contact with blood.
“When people have HIV, some doctors say ‘we can’t do anything’ – they are afraid of surgery,” says Mardari.
Medical staff will often tell carriers to stay in a corner in the waiting room, far away from other patients.
There is also little respect for confidentiality. Moldovan ex-drug user Maria says that when she was in the hospital, a nurse asked her how she contracted HIV.
“I told the nurse: ‘when you come to consult me, you shouldn’t be looking through my underwear’.”
A major problem is that medical care systems in these countries are under massive pressure.
In Moldova the system suffers from doctors leaving to work abroad for higher salaries and a lack of financing from central Government.
Meanwhile Ukraine’s state apparatus faces economic collapse, endemic corruption and war.
Both countries suffer from poverty.
Therefore first to face prejudice are drug users and HIV carriers, because wider society views their conditions as the product of indulgent lifestyle choices.
“No money, no funny”
Bribery is widespread in the medical systems in ex-Communist nations, which is made more acute for those with HIV.
I meet women who have sold all their gold to pay for lab tests, which should be free under state healthcare, or who bribed doctors with chocolate and cognac for laparoscopic surgery.
Kyiv-based Tatiana never used drugs. When she was seven months pregnant she had an HIV test, together with her husband. Both found out they had HIV and she had cancer of the cervix.
When the son was three months’ old, she went to a specialist hospital in oncology to treat her cancer.
The doctors delayed her operation.
“They told me they do not have the drugs nor a place for me to stay,” Tatiana says.
“When she came in to the hospital, she was treated like a ‘white woman’,” adds legal advisor Iulia Dorohova, who observed her case, “but as soon as they found out she was HIV, she was treated as rubbish.”
But when Tatiana’s mother began to pay off the doctors in cash, she received attention.
To secure a consultation, her mother would come to the hospital and put 500 Hrvnia (about 25 Euro) in the pocket of the doctor’s lab-coat.
However one time she only had 300 Hrvnia (15 Euro). As per normal, she placed this amount in the doctor’s coat.
A minute later the doctor returned, disgusted, and threw the 300 Hrvnia into the woman’s lap.
It was too small an amount.
“The doctors want money,” says Dorohova, rubbing her fingers. “No money, no funny.”
“They cut me and sewed me up like a dog”
Not only HIV patients face discrimination, but also drug users with Hepatitis C, a highly infectious blood-borne virus which damages the liver.
29 year-old drug user Larisa from Balti, Moldova, recently had an ectopic pregnancy.
“I didn’t know I was pregnant,” she says. “I prepared for the operation. I was on the operating table, where a nurse told me: ‘tell me about your sickness’. I told them I had Hep C. She shouted this information to everyone in the hall of the hospital.
“They saw the tracks on my arm and their attitude changed. They cut me and sewed me up like a dog.
“When I stayed in the hospital, I prayed that they would give me pills so I could sleep.
“But when I asked the doctor for medication, he told me: ‘All those drugs you took weren’t enough, you want others?’”
“Only after six months could I feel she was my baby”
When drug users and HIV carriers give birth, a major problem is the attitude of medical staff to the new mothers.
“In the centre when I gave birth, no one cleaned,” says Maria from Moldova. “With the child, no one helped. They told me: ‘you are a mother with experience, carry this out alone’. They make a fool out of you when they discover you have HIV.”
In Ukraine, all pregnant female drug users reported discrimination during and after labor, among interviews for an EU-funded report in 2012 ‘Violation of the right of female drug users to access to medical and social services’.
One of the most shocking aspects of this study were examples of doctors asking female drug users to put their babies up for adoption.
Many drug using women give birth prematurely and medical staff often prevent them from seeing their newborns in the hospital.
Detailed in the report, Tetiana from Kyiv bore her baby at 28 weeks. The baby spent six months in an incubator, where the doctors saved her.
“I was not allowed to see her,” she says. “They were afraid of me because I was a drug user.
“They found various excuses. They said: ‘You do not feed her? Then why do you have to be with her?’.
“I did not see my baby because they wouldn’t let me in her room for six months. I brought in medicine and milk.
“Only half a year after her birth, could I have her in my arms, hug her and kiss her, and feel that she is my baby.”
Michael Bird
Thanks to Oxana Greadcenco, Elena Gutanu, Irina Titica, Lina Vdovii, Ilie Cazac, Inga Malisauskaite, Erika Matuzaite and the staff from the HIV Social Centers in Balti and Chisinau for help with this article
This article was financed with the Award for Best Initiatives of European Online Investigative Journalism, Robert Schuman Centre for Advanced Studies (European University Institute, Florence, Italy) and supported through moldova.org by ‘Fortification of the independence of online mass-media in the Republic of Moldova through the transfter of Know-how from the EU’ – with support from the ‘European Partnership for Democracy’ and financial resources from the ‘National Fund for Democracy’ (NED).
Society
“They are not needy, but they need help”. How Moldovan volunteers try to create a safe environment for the Ukrainian refugees
At the Government’s ground floor, the phones ring constantly, the laptop screens never reach standby. In one corner of the room there is a logistics planning meeting, someone has a call on Zoom with partners and donors, someone else finally managed to take a cookie and make some coffee. Everyone is exhausted and have sleepy red eyes, but the volunteers still have a lot of energy and dedication to help in creating a safe place for the Ukrainian refugees.
“It’s like a continuous bustle just so you won’t read the news. You get home sometimes and you don’t have time for news, and that somehow helps. It’s a kind of solidarity and mutual support,” says Vlada Ciobanu, volunteer responsible for communication and fundraising.
The volunteers group was formed from the very first day of war. A Facebook page was created, where all types of messages immediately started to flow: “I offer accommodation”, “I want to help”, “I want to get involved”, “Where can I bring the products?”, “I have a car and I can go to the customs”. Soon, the authorities also started asking for volunteers’ support. Now they all work together, coordinate activities and try to find solutions to the most difficult problems.
Is accommodation needed for 10, 200 or 800 people? Do you need transportation to the customs? Does anyone want to deliver 3 tons of apples and does not know where? Do you need medicine or mobile toilets? All these questions require prompt answers and actions. Blankets, sheets, diapers, hygiene products, food, clothes – people bring everything, and someone needs to quickly find ways of delivering them to those who need them.
Sometimes this collaboration is difficult, involves a lot of bureaucracy, and it can be difficult to get answers on time. “Republic of Moldova has never faced such a large influx of refugees and, probably because nobody thought this could happen, a mechanism of this kind of crisis has not been developed. Due to the absence of such a mechanism that the state should have created, we, the volunteers, intervened and tried to help in a practical way for the spontaneous and on the sport solutions of the problems,” mentions Ecaterina Luțișina, volunteer responsible for the refugees’ accommodation.
Ana Maria Popa, one of the founders of the group “Help Ukrainians in Moldova/SOS Українці Молдовa” says that the toughest thing is to find time and have a clear mind in managing different procedures, although things still happen somehow naturally. Everyone is ready to intervene and help, to take on more responsibilities and to act immediately when needed. The biggest challenges arise when it is necessary to accommodate large families, people with special needs, for which alternative solutions must be identified.
Goods and donations
The volunteers try to cope with the high flow of requests for both accommodation and products of all kinds. “It came to me as a shock and a panic when I found out that both mothers who are now in Ukraine, as well as those who found refuge in our country are losing their milk because of stress. We are trying to fill an enormous need for milk powder, for which the demand is high and the stocks are decreasing”, says Steliana, the volunteer responsible for the distribution of goods from the donation centers.
Several centers have been set up to collect donations in all regions of Chisinau, and volunteers are redirecting the goods to where the refugees are. A system for processing and monitoring donations has already been established, while the volunteer drivers take over the order only according to a unique code.
Volunteers from the collection centers also do the inventory – the donated goods and the distributed goods. The rest is transported to Vatra deposit, from where it is distributed to the placement centers where more than 50 refugees are housed.
When they want to donate goods, but they don’t know what would be needed, people are urged to put themselves in the position of refugees and ask themselves what would they need most if they wake up overnight and have to hurriedly pack their bags and run away. Steliana wants to emphasise that “these people are not needy, but these people need help. They did not choose to end up in this situation.”
Furthermore, the volunteer Cristina Sîrbu seeks to identify producers and negotiate prices for products needed by refugees, thus mediating the procurement process for NGOs with which she collaborates, such as Caritas, World Children’s Fund, Polish Solidarity Fund, Lifting hands, Peace Corps and others.
One of the challenges she is facing now is the identifying a mattress manufacturer in the West, because the Moldovan mattress manufacturer that has been helping so far no longer has polyurethane, a raw material usually imported from Russia and Ukraine.
Cristina also needs to find solutions for the needs of the volunteer groups – phones, laptops, gsm connection and internet for a good carrying out of activities.
Hate messages
The most difficult thing for the communication team is to manage the hate messages on the social networks, which started to appear more often. “Even if there is some sort of dissatisfaction from the Ukrainian refugees and those who offer help, we live now in a very diverse society, there are different kind of people, and we act very differently under stress,” said Vlada Ciobanu.
Translation by Cătălina Bîrsanu
Important
#WorldForUkraine – a map that shows the magnitude of the world’s actions against Russian aggression
The international community and volunteers from all over te world have launched #WorldForUkraine as a platform that shows the magnitude of the world’s actions against the Russian aggression. In a digital world – it is an interactive map of public support of Ukrainians under the hashtag #WorldForUkraine – rallies, flash mobs, protests around the world. In the physical dimension – it is your opportunity to take to the streets and declare: “No to Putin’s aggression, no to war.”
„Today, along with the political and military support, emotional connection with the civilized world and truthful information are extremely important for Ukraine. The power to do it is in your hands. Join the #WorldForUkraine project and contribute to the victorious battle against the bloodshed inflicted on Ukraine by the aggression of the Russian Federation”, says the „about the project” section of the platform.
Go to the streets — Tell people — Connect and Unite — Become POWERFUL
Volunteers have launched #WorldForUkraine as a platform that shows the magnitude of the world’s actions against Russian aggression. In digital world – it is an INTERACTIVE MAP of public support of Ukrainians worldforukraine.net under the hashtag #WorldForUkraine – rallies, flash mobs, protests around the world. In the physical dimension – it is your opportunity to take to the streets and declare: “No to Putin’s aggression, no to war.” There you may find information about past and future rallies in your city in support of Ukraine. This is a permanent platform for Ukrainian diaspora and people all over the world concerned about the situation in Ukraine.
So here’s a couple of things you could do yourself to help:
* if there is a political rally in your city, then participate in it and write about it on social media with geolocation and the hashtag #WorldForUkraine
* if there are no rallies nearby, organize one in support of Ukraine yourself, write about it on social media with geolocation adding the hashtag #WorldForUkraine
The map will add information about gathering by #WorldForUkraine AUTOMATICALLY
Your voice now stronger THAN ever
All rallies are already here: https://worldforukraine.net
Important
How is Moldova managing the big influx of Ukrainian refugees? The authorities’ plan, explained
From 24th to 28th of February, 71 359 Ukrainian citizens entered the territory of Republic of Moldova. 33 173 of them left the country. As of this moment, there are 38 186 Ukrainian citizens in Moldova, who have arrived over the past 100 hours.
The Moldovan people and authorities have organized themselves quickly from the first day of war between Russia and Ukraine. However, in the event of a prolonged armed conflict and a continuous influx of Ukrainian refugees, the efforts and donations need to be efficiently managed. Thus, we inquired about Moldova’s long-term plan and the state’s capacity to receive, host, and treat a bigger number of refugees.
On February 26th, the Ministry of Labor and Social Protection of Moldova approved the Regulation of organization and functioning of the temporary Placement Center for refugees and the staffing and expenditure rules. According to the Regulation, the Centers will have the capacity of temporary hosting and feeding at least 20 persons, for a maximum of 3 months, with the possibility of extending this period. The Centers will also offer legal, social, psychological, and primary medical consultations to the refugees. The Center’s activity will be financed from budget allocations, under Article 19 of Provision no. 1 of the Exceptional Situations Commission from February 24th, 2022, and from other sources of funding that do not contravene applicable law.
The Ministry of Inner Affairs and the Government of Moldova facilitated the organization of the volunteers’ group “Moldova for Peace”. Its purpose is to receive, offer assistance and accommodation to the Ukrainian refugees. The group is still working on creating a structure, registering and contacting volunteers, etc. It does not activate under a legal umbrella.
Lilia Nenescu, one of the “Moldova for Peace” volunteers, said that the group consists of over 20 people. Other 1700 registered to volunteer by filling in this form, which is still available. The group consists of several departments:
The volunteers’ department. Its members act as fixers: they’re responsible for connecting the people in need of assistance with the appropriate department. Some of the volunteers are located in the customs points. “The Ministry of Inner Affairs sends us every day the list of the customs points where our assistance is needed, and we mobilize the volunteers”, says Lilia Nenescu.
The Goods Department manages all the goods donated by the Moldavian citizens. The donations are separated into categories: non-perishable foods and non-food supplies. The volunteers of this department sort the goods into packages to be distributed.
The Government intends to collect all the donations in four locations. The National Agency for Food Safety and the National Agency for Public Health will ensure mechanisms to confirm that all the deposited goods comply with safety and quality regulations.
The Service Department operates in 4 directions and needs the volunteer involvement of specialists in psychology, legal assistance (the majority of the refugees only have Ukrainian ID and birth certificates of their children); medical assistance; translation (a part of the refugees are not Ukrainian citizens).
According to Elena Mudrîi, the spokesperson of the Ministry of Health, so far there is no data about the number of Covid-19 positive refugees. She only mentioned two cases that needed outpatient medical assistance: a pregnant woman and the mother of a 4-day-old child.
The Accommodation Department. The volunteers are waiting for the centralized and updated information from the Ministry of Labor about the institutions offering accommodation, besides the houses offered by individuals.
The Transport Department consists of drivers organized in groups. They receive notifications about the number of people who need transportation from the customs points to the asylum centers for refugees.
The municipal authorities of Chișinău announced that the Ukrainian children refugees from the capital city will be enrolled in educational institutions. The authorities also intend to create Day-Care Centers for children, where they will be engaged in educational activities and will receive psychological assistance. Besides, the refugees from the municipal temporary accommodation centers receive individual and group counseling.
In addition to this effort, a group of volunteers consisting of Ana Gurău, Ana Popapa, and Andrei Lutenco developed, with the help of Cristian Coșneanu, the UArefugees platform, synchronized with the responses from this form. On the first day, 943 people offered their help using the form, and 110 people asked for help. According to Anna Gurău, the volunteers communicate with the Government in order to update the platform with the missing data.
Translation from Romanian by Natalia Graur
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