Increased Access to Healthcare Facilities for Pregnant Women who Use Drugs in Kyrgyzstan

A total of 8,392 people living with HIV (PLHIV) were registered in the Kyrgyz Republic on 1 July 2018. Transmission of HIV is connected to drug use. Recently, sexual transmission has become a popular mode of transmission as well. While the total registered injecting HIV cases have decreased by almost 30% over the past nine years (2008-2017), the incidence of drug use in certain regions of Kyrgyzstan remains high. Moreover, the number of new HIV cases among women increased by almost 10% over the past nine years (2008-2017).

In Kyrgyzstan, women who use drugs still have limited access to obstetrics-gynaecology services and often face stigma and discrimination from the medical staff. With a lack of knowledge among doctors on how to best support and treat pregnant women with substance dependence, women were sent to abortion clinics even after the acceptable period for termination of pregnancy. In general, it was not known that women who use drugs could get healthy children. Women who use drugs themselves were also afraid to be denied medical care when doctors would find out they used drugs.

A working group composed of the Kyrgyz community-led organisation (CBO) Asteria and representatives of the Ministry of Health, National Centre of the mother and child protection, National Narcology Centre, and State Institute of postgraduate education and a specialist on evidence for medicine was set up and coordinated by AFEW Kyrgyzstan.  A new clinical protocol was developed reflecting the needs of women who use drugs under the guidance of these women themselves. The clinical protocol Care in pregnancy, childbirth and the puerperium for women who use psychoactive substances was developed and approved as a Clinical Guideline by Kyrgyz Ministry of Health in January of 2017.

Medical staff in Kyrgyzstan was subsequently trained on implementation of the guideline. A representative of the Kyrgyz State Medical Institute for post-graduates reported that the knowledge of the doctors increased by 80% after trainings have been carried out. So far, 100 staff of the medical Institute and gynaecologists at the primary health care and maternity hospitals of Bishkek and Osh have been trained.  The implementation of the clinical guideline is under control of the Ministry of Health of Kyrgyz Republic. Stigma and discrimination from health care providers and policymakers against women who use drugs have decreased significantly. Service providers now understand better that proper care during pregnancy for all is a chance for improving the health of mother and child.

“I used drugs for 10 years, was detained several times, was released, and lived without documents. Then I joined the Opioid Substitution Therapy (OST) programme, restored my documents, got a job, got married. When I applied for medical services when I was pregnant, the doctor insisted on an abortion, saying that the child would be born inferior. I gave birth; the child is healthy, now he is 2 years old and 7 months”.

L. PF Podruga, Osh, a client of a community centre for women who use drugs

With the support of the Bridging the Gaps programme, it was possible to integrate harm reduction with sexual reproductive health and rights for women who use drugs. Sustainability of the guideline’s implementation has been secured thanks to the inclusion in the National Medical Institute of Postgraduate Education and the World Health Organisation’s Compendium of good practices in the health sector response to HIV in the WHO European Region. AFEW-Kyrgyzstan closely monitors the implementation of the guideline.

AFEW International and Partners Start Implementing a New Project in Russia and Kyrgyzstan

Anke van Dam (on the right) and Daria Alexeeva presented the project in Russia. Photo: E.V.A.

Starting from January 2019, AFEW International began to implement the project St. Petersburg and Bishkek – Key Populations and HIV & TB Prevention Priorities funded through the Aidsfonds under the PITCH. The project covers key populations and HIV and tuberculosis prevention priorities in St. Petersburg, Russia and Bishkek, Kyrgyzstan.

PITCH is a strategic partnership between Aidsfonds and the Frontline AIDS (former International HIV/AIDS Alliance) working with those most affected by HIV: adolescent girls and young women, LGBTI, people who use drugs, prisoners and sex workers. The program aims to enable these groups to transform (inter)national HIV responses by strengthening their advocacy skills and capacities and promoting the innovative evidence-informed practice. This will contribute to cities in the Russian Federation and Eastern Europe and Central Asia (EECA) joining the fast-track city initiative and building political support for an HIV/AIDS response focused on key populations.

“Within this project, we are focusing on working with St. Petersburg and Bishkek and municipal level governments on HIV geographically-focused responses,” says AFEW International’s program manager Daria Alexeeva. “In this way, we are continuing our work we stared under the Fast-track Cities project in partnership with Alliance for Public Health where we are developing models of sustainable city responses to HIV and TB in key population in EECA that significantly contribute to achieving 90-90-90 HIV/TB targets for key populations.”

The project St. Petersburg and Bishkek – Key Populations and HIV & TB Prevention Priorities will work on several strategies: community based participatory research to reveal the most acute needs of the key populations, changing attitude of the decision maker towards key groups, involving key groups into the advocacy process, and experience exchange between the three countries, negotiations with the cities authorities on signing Paris Declaration and Zero TB Declaration.

AFEW-Kyrgyzstan Opened a Youth Centre in Bishkek

Author: Grana Ziia, AFEW-Kyrgyzstan

On March 19, the ground floor of the Palace of Sports in Bishkek was crowded: teenagers, civil servants, representatives of the city hall and non-governmental organisations, social workers of district administrations and AFEW-Kyrgyzstan team all gathered together for the opening ceremony of a new youth centre.

In the spacious hall, decorated with felt paintings and bright red wallpapers, the Deputy Director of the State Agency for Youth Affairs, Physical Culture and Sports Mirlan Parkhanov welcomes all the guests. He says that this centre was opened last year to organise events and conferences for young people.

– Now, with the support of AFEW-Kyrgyzstan, a teenage centre is opened here. A psychologist and a social worker are now working here. They will organise free counselling for adolescents and their parents, organise useful leisure activities for young people, those who wish can join sport clubs and do other extracurricular activities, – Mr. Parkhanov is saying and inviting all guests for a tour around the centre.

The most important thing is to have trust from children

Guests are entering the interactive room. Judging by the interest with which they take pictures there, they like this room very much. Inside there is a dozen of bright fashionable beanbags, a shelf with board games and brochures about health, family planning, and drug use prevention. On the walls, there are posters with the rules of the centre and announcements of various competitions and grants for young people. There is a computer, a projector and a big screen for teenagers in the corner of the room.

Another room is a room for the staff of the centre and individual consultations of adolescents with a psychologist, social workers and other specialists. It is cosy here. There are also felt paintings and framed carpet, cookies on the table, and a few pillows on the sofa.

– We tried to create the most relaxed atmosphere here so that the children can trust us. I hope it worked out! – says the psychologist of the centre Margarita.

A place for useful leisure and development

After the tour, the guests gather in the conference room again. AFEW-Kyrgyzstan manager Chinara Imankulova begins the presentation of the services of the youth centre and talks about the idea of opening the centre.

– Last year, with the support of the Central Asia Drug Action Programme (CADAP), AFEW-Kyrgyzstan conducted a study on the prevalence of psychoactive substances usage among adolescents in Kyrgyzstan. The data obtained showed that it was time to begin working on prevention. Thus, this centre appeared. We want all teenagers to come here, and not just those who use psychoactive substances or are in a difficult life situation. Here, teenagers will have a safe space to relax, to talk to their peers and get professional support, – says Chinara.

The psychologist and social worker of the centre add that this form of work with adolescents is the most effective. When children come from different groups, they communicate with each other, share interests and help each other. Therefore, no one feels deprived and lonely.

Joined efforts are needed

In her presentation, Chinara is saying that the centre will also function to increase the capacity of psychologists, social workers and pedagogues, doctors and juvenile inspectors. Guests perceive the news with enthusiasm, because, according to them, there is a need for constant professional growth.

The guests of the event are also saying that Bishkek needs such a centre for a long time. They also talk about the problems they face in their practice. After the discussion, they develop a plan of cooperation with the centre: how to guide children, how to interest them, how to organise training sessions.

Employees of professional lyceums are saying that they are ready to hold master classes for teenagers; representatives of the city hall promise to help with the transportation for outdoor events; the department of physical culture and sports is ready to engage teenagers from the centre in free sports activities. After all, only with joined efforts, we can build a healthy future.

AFEW-Kyrgyzstan Opens a Social Beauty Salon in Bishkek

Head of AFEW-Kyrgyzstan Natalya Shumskaya is cutting the red ribbon during the ceremony of opening the salon

Author: Grana Ziia, AFEW-Kyrgyzstan

March 7, Bishkek, Kyrgyzstan

The city is stuck in pre-holiday traffic jams. Flower stands with colourful tulips are opening near a big shopping mall. Today flowers are in demand among the guests of a new beauty salon called Good Luck. They are doing their best to come in time for the opening ceremony. The salon is located in the city centre, surrounded by popular coffee houses, schools and apartment buildings. There is a red ribbon at the entrance to the salon. Music is playing. The guests are holding bright flowers, balloons, and cakes in their hands. Everyone is hugging, greeting each other and congratulating the AFEW-Kyrgyzstan team. It is easy to tell what the reason for such joy is.

“Good Luck is a ‘kind’ beauty studio – a social enterprise established to support women in difficult life circumstances. We opened it with the support of the UN Women Fund for Gender Equality. We are implementing a project, where women can attend workshops to develop their personal skills and knowledge of the economy and then receive mini-grants to start their own businesses. When we saw that there were many women who needed our support, we decided that we wanted to develop this area of our activities,” tells Natalya Shumskaya, head of AFEW-Kyrgyzstan, before cutting the red ribbon.

Supporting those who need support

In several minutes, the guests come inside. In the main room, they are welcomed by the staff members – six women in snow-white uniforms. They have happy smiles on their faces and are proudly fixing their badges. In the room, there are black chairs for make-up artists and hairdressers, a long manicure table and mirrors with bright lights.

AFEW-Kyrgyzstan opened a social beauty salon with the support of the UN Women Fund for Gender Equality

The studio looks like a cosy house, where every detail is chosen with love. The pink wall in the centre of the room has been painted by the salon staff. There are bright pillows on the couch and glossy magazines on the glass table. Lots of flowers and balloons. Make-up, shampoos and hair dye tubes on the shelves. You just feel like touching, watching and trying everything here.

After the welcoming speeches, the Good Luck salon gets noisy. The clients in their chairs are turning catalogues to choose their nail polish, discussing their haircuts with hairdressers or choosing the colour of their eyebrows. Someone is already washing hair. At first sight, it looks like those are just ordinary people preening their feathers on the eve of the International Women’s Day. However, if you listen to people talking, it becomes clear that it is not so simple.

“For us it is close, so we will come and support them. It is good when all the money earned goes to help women who need help,” shares her thoughts Aida Karagulova, Director of the City AIDS Centre.

Women will be trained

Natalya Shumskaya is sure that this beauty studio will become a turning point in someone’s life

Clients were satisfied with the services they received. The guests were making photos and paying compliments to each other. With their new haircuts, make-up and nails done, they went on to finish their festive preparations.

“We have a training centre here at the salon, where we plan to train women in difficult life circumstances to become beauty salon artists so that they can find jobs,” says Indira, the salon manager, taking us on a tour to show the premises.

Natalya Shumskaya presents a flower in a big pot to the studio and it takes an honourable place at the entrance. The flower is called Women’s Bliss.

“Here it is a good place for this plant as this salon works for those who are looking for their bliss so hard! I am sure that this beauty studio will become a turning point in someone’s life, helping to find a job, start a new career and believe in the woman’s power and right to independence,” says Natalya Shumskaya before she leaves the salon.

People who Use Drugs Deserve Love, Respect and Support

Author: Grana Ziia, AFEW-Kyrgyzstan

Sergey Bessonov from Bishkek is the head of the organization that protects the rights of people who use drugs (PWUD) – “Harm Reduction Network Association” (HRNA). Sergey himself used drugs in the past. However, he admits that everyone has the right to make his own choice whether to stop using drugs or not.

Now Sergey dedicates his life to the community of people who use drugs. In his interview with AFEW-Kyrgyzstan, Sergey is talking about the challenges of the community of people who use drugs in Kyrgyzstan, drug policy and his future plans. Below are some of Sergey’s thoughts in direct speech.

About the desire to be heard

For a long time, the problem of drug use was solved by using strict bans: prisons, fines, and information that PWUDs are no longer members of our society, that they are somehow bad, dangerous… I myself know a lot of people who died from the overdose, I saw people who spent most of their lives in prisons for using soft drugs. These people were left without work, housing and the possibility to live the life they wanted to.

Now in Kyrgyzstan, the government started to understand that a progressive drug policy cannot be built without a community. However, it is very important for us that the community participation in the development of programs was not just for show. We want our opinion to be respected, considered and trusted. We need the possibility of professional growth.

About the professional growth

The project “Bridging the Gaps: Health and Rights for Key Populations” (BtG) started to help us a few years ago. Over the past two years, this project gave people from the community the possibility to take part in trainings on negotiation skills, legal monitoring by the community, analysis of regulatory legal acts.

These trainings helped us to develop some of our skills. Using this knowledge, people from our community started to develop their own organisations, participate in working groups with governmental representatives and implement advocacy programs.

About the new drug policy

Last year, our country started talking about changes in criminal and administrative codes. Governmental representatives finally understood that sending people who use drugs to prison instead of rehabilitation and harm reduction programs is ineffective and cruel.

During the analyses of new regulatory acts that HRNA conducted with the support of the BtG project and AFEW-Kyrgyzstan, we found some negative changes. For example, new amendments, which now started to work, increased the fine for carrying and possession of drugs twice. The new fine is unaffordable, which means that people will again be imprisoned. Now we are negotiating with international and state structures, with other NGOs and explaining to them why this novelty needs to be revised.

BtG also provided us with an opportunity to conduct focus groups among PWUDs. We found out that not all people are aware of the new laws. This creates extortion and corruption. Now we are constantly monitoring new cases of detention of drug users and support people who use drugs.

About the alternative to prisons

According to the new offense code of Kyrgyzstan, alternative punishment that is called probation is provided for people who use drugs and who have committed any kind of offense. Therefore, now a person has an opportunity to avoid prison.

The initiative itself is very good and we now have a lot of work for its successful implementation. We have already come to the agreement with several probation services and they are letting us know if a person who uses drugs came to them.

HRNA also plans to work with judges to explain that we should punish people only for offenses, not for using drugs. People in our country still have many stereotypes towards people who use drugs. These stereotypes can influence judges’ decisions about sending a drug user to prison or probation.

About the needs of the community

People who use drugs almost always remain alone. Parents turn away from them, doctors reject to help, friends betray them, mass media use offensive words, police suspect them in all crimes. Sometimes we become the only home and friend for each other. With our examples, we show that people who use drugs deserve love and respect.

To help our community to be strong and united, the BtG project is supporting our dialogue platform. Thanks to this, we can meet, discuss and stay united. I feel that the community is getting stronger and more confident with years passing by.

Together we build a liberal healthy future in Kyrgyzstan, where every person can get help and fulfill their potential.

Natalya Shumskaya: “Without a Professional Team We Would Not Have Succeeded”

Author: Grana Zia, AFEW-Kyrgyzstan

The executive director of AFEW-Kyrgyzstan Natalya Shumskaya is talking about the successes and challenges of the organisation in 2018 and the new demands for 2019.

– Natalia, what are the main achievements that AFEW-Kyrgyzstan can be proud of in 2018?

– I am really proud that the World Health Organisation (WHO) recognized the clinical guideline we developed for the management of pregnancy among women who use psychoactive substances as the best practice.

In the women’s colony, where we work in partnership with the Penal Medical Service and the Republican AIDS Centre, we managed to achieve the goal of 90-90-90: 90% of HIV-positive people are aware of their status, 90% of them take antiretroviral (ARV) therapy and reach supressed viral load. This is our common contribution to the fight against the HIV epidemic, and it is very encouraging to see such results.

I am also proud that we have managed to develop guidelines for the effective functioning of the coordination commissions on HIV infection and tuberculosis. Under this guideline, we trained over 100 representatives of regional public health commissions in all regions of Kyrgyzstan. We successfully lobbied for the participation of civil society organisations in these commissions.

Remembering 2018, I should also mention the delegation from Kyrgyzstan at the International AIDS Conference in Amsterdam AIDS 2018. We have been looking for funding for a long time, negotiating with various donors. Here is our result: 16 participants from Kyrgyzstan took part in more than 15 sessions; six delegates from Kyrgyzstan became conference speakers, and five delegates took part in poster presentations. At AIDS 2018, we even organized our own workshop for the countries of the Eastern European and Central Asian (EECA) region on community participation in decision making at all levels. I consider this a success, and, taking into the account the huge amount of work for this case, I call this a great achievement.

I am also proud that in 2018 we were able to agree with AFEW International and UN-Women in Kyrgyzstan on the opening of a rehabilitation centre and a social enterprise. It was a long process of negotiating, but we were able to take this step for the sake of healthy future for our country.

– What were your main challenges in 2018?

– I think that challenges are, first of all, opportunities. For example, in 2018 we planned the opening of a centre for teenagers for the prevention of usage of psychoactive substances. It was important for us that the state also contributed to the opening of this centre. We wanted to emphasize the importance of investing in youth development by the state. Children need our help. Unfortunately, negotiations with the mayor’s office were very long. It took us a very long time to receive a huge amount of necessary permits. We organized meetings, made concessions, but we were rejected. In early 2019, the opportunity arose to open such a centre in partnership with the State Agency for Youth, Physical Culture and Sports under the Government. They gave us a large and warm room in the heart of the city of Bishkek. Starting from March, our centre for teenagers begins its work.

– What are the main goals for AFEW-Kyrgyzstan in 2019?

– First of all, we plan to start our social entrepreneurship. We have already opened a training centre and beauty studio. We plan to train women in difficult life situations and to employ them later to work in the beauty studio. Now the important task is to think about marketing strategy and put everything on a self-sufficiency track. For us, this is a new experience. Now we will master fashionable beauty services, understand all the difficulties of accounting and business.

Another goal is to ensure stable development and financial support of our rehabilitation centre. It is being built now with the support of AFEW International. We want it to be a high-quality, multi-functional, modern and convenient for people who use drugs. We do not accept “semi-results”, and will definitely achieve all the goals.

Of course, 2019 will be for us a year of searching for new directions and programs, and strengthening advocacy activities, especially in the field of budget advocacy from the state. We want to strengthen relations with the donor community, non-governmental organisations and the state.

– Natalia, what do you think distinguishes AFEW-Kyrgyzstan from other non-governmental organisations in Kyrgyzstan?

– I think our strongest point is our employees. Due to the fact that our entire team is people with completely different education and experience, we can work in a very large range of services. Among us there are specialists in the field of HIV, tuberculosis, gender experts, researchers, business consultants. In 2017, for example, we began to develop the direction of helping women in difficult life situations. It was the first experience, but now this direction is very successful: 320 women from various key groups (single mothers, victims of gender-based violence, HIV-positive women) had training on the development of economic independence. Some of them started their business after that, someone has already come to our beauty studio as a master or coach. Without a professional team that is ready for new challenges, we would not have succeeded.

Dreams of the “Invisible” Women in Kyrgyzstan

Author: Grana Ziia, AFEW-Kyrgyzstan

A photo exhibition “Dreams of the Invisible Women” was held in Bishkek, Kyrgyzstan from November 25 to December 10, 2018. The exhibition, which was held in the centre of Bishkek and in the venues popular among young people, allowed women suffering from violence, discrimination, living with HIV or using drugs as well as LBT women to send a message to the society: “We are here! We also love and are loved, we deserve to be happy and have equal rights.”

The photo exhibition was initiated by Asteria Foundation with the UNAIDS support. The photo models were participants of Bridging the Gaps: Health and Rights for Key Populations project. The exhibition was held within the 16 Days of Activism Against Gender-Based Violence Campaign, and its opening was dedicated to the World AIDS Day.

“Invisible women” face violence, they become hostage to an endless cycle of abuse, guilt and discrimination. People judge them and tell them: “That’s all your fault!” Often, drugs are the only way for them to run away from their pain, shame and despair. Due to the social stigma, women from the key populations almost never seek help, they are afraid that people will not understand them and will reject them. That is why their problems are invisible for the state and for the society,” says Irena Ermolayeva, Director of the Asteria Charitable Foundation.

Asteria’s statistics confirm this situation. According to the data available, all women from vulnerable populations who have families or intimate partners are exposed to different forms of violence. However, 80% of such women do not seek any help as they are afraid to face stigma and discrimination again.

“This campaign is very important for us. It opens new opportunities for women who use drugs, lesbians, trans women, women living with HIV and women who suffer from violence and show the issue from a different perspective. The main goal of the exhibition is not to “draw” a victim and not to label women, but to focus on the fact that first of all they are human beings and, thus, should have equal rights. I hope that this campaign will change the attitude of our society to thousands of women who are the same as the heroines of our exhibition,” says Irena Ermolayeva.

“Invisible women” are first and foremost someone’s mothers, who love and are loved, someone’s friends and relatives. They need the society to stop viewing them as a problem and to recognize their right to live free, happy and safe lives. They dream to be protected by law and by the state.

AFEW-Kyrgyzstan Started the Year with Rebranding

By changing the name “AIDS Foundation East-West in the Kyrgyz Republic” at the beginning of the year 2019, AFEW-Kyrgyzstan emphasized its involvement in the international AFEW Network. Another reason for changing the name and logo of the organisation is the expanding capabilities.

“Now we are working not only in the field of HIV and AIDS. We are implementing tuberculosis treatment projects, conducting large-scale researches, carrying out advocacy campaigns to protect the rights of people and for the economic empowerment of women. Therefore, the former name no longer fully reflects our goals and values,” says the Chair of the Board of AFEW-Kyrgyzstan Natalia Shumskaya.

The new logo has retained one of the key elements of the previous one – the human figure, because everything AFEW does is aimed at helping specific people. The figure also shows that AFEW-Kyrgyzstan works, involving people from the community, and for them.

Three blue and one red objects around the white pattern represent different countries since AFEW-Kyrgyzstan is a part of an international network and is ready to use the experience of foreign partners to build a healthy future in the country.

In an updated form, AFEW-Kyrgyzstan is ready to welcome its old partners again and look for new opportunities to help people from key populations.

AFEW-Kyrgyzstan Uses the Experience of Foreign Colleagues

216 adolescents were registered for using psychoactive substances in 2017, according to the Narcology Center in Bishkek. Representatives of the police services in Bishkek stated that there is also a high possibility that 1,031 teenagers, who were registered for committing different offences in 2018, had an experience of using psychoactive substances or are at a high risk of starting to do so. However, this data does not show the real situation. In Kyrgyzstan, there are still no complete official data on the exact number of adolescents who use psychoactive substances.

This is related to several factors. One of them is that the drug policy of the country is still strict and aimed to punish. Parents and children who face the problem of using psychoactive substances are afraid of getting help from medical specialists because the doctors will add teenager’s name to the special database. In the future, being in this database will not allow this teenager to be enrolled at the university or to get a high-paid job.

Another issue is that the country is lacking ways to support such adolescents. There is also a lack of a comprehensive program for the prevention of drug use among teenagers. The combination of all these factors does not allow the country’s specialists to work effectively with adolescents and to carry out preventive work.

Bridging the Gaps: health and rights of key populations (BtG) project, implemented by AFEW-Kyrgyzstan, intends to apply international experience to help adolescents who use psychoactive substances in Kyrgyzstan. BtG has regional exchange platforms, where specialists from EECA can share with each other their experience concerning harm reduction and rehabilitation issues. It helps the project to meet contemporary challenges. AFEW-Kyrgyzstan is aiming at creating a multifunctional mechanism that will help adolescents who use psychoactive substances and a professional system for preventive teenagers from using it.

The protocol is approved by the Ministry of Health

The clinical protocol ‘Mental and behavioural disorders due to the usage of new psychoactive substances among children and adolescents’ was developed with the support of AFEW-Kyrgyzstan and approved by the Ministry of Health in 2017. Professional narcologists and members of the community of people who use psychoactive drugs and other specialists developed the protocol.

“The developed clinical protocol gives the recommendations to emergency medical doctors, toxicologists, family doctors, resuscitators, psychiatrists and narcologists,” says Elmira Kaliyeva, a participant of the working group that developed the protocol.

Having developed the protocol, AFEW-Kyrgyzstan began trainings for narcologists, doctors of family medicine centres, teachers of the Kyrgyz State Medical Institute for post graduates and juvenile inspectors in Bishkek and Osh.

Working for the future

The representatives of the UN Children’s Fund (UNICEF) got interested in the protocol too and the BtG work and approached AFEW-Kyrgyzstan with a proposal to teach doctors in remote areas of Bishkek to work with this protocol. The proposal of UNICEF gave the opportunity to expand the circle of specialists familiar with the protocol. In addition, this cooperation will allow AFEW-Kyrgyzstan to be confident that all the work done in the framework of the BtG project will continue in the country for many years.

Waiting for the city hall’s help

Establishing cooperation with government partners to ensure stable and long-term support for adolescents who use drugs was the next task of the project. In June 2018, within BtG project, AFEW-Kyrgyzstan supported a round table organized by the city administration for the presentation of the Comprehensive City Program Prevention of Juvenile Offenses for 2018-2020.

Deputies promised to consider the proposed Comprehensive City Program which also includes recommendations that were listed in the developed clinical protocol. The adoption of the program will allow to create a cross-sectorial system of cooperation in the country, where the various departments can work together and redirect children who use psychoactive substances to help them as efficiently as possible.

Opening a centre for teenagers

The round table also became a platform for discussing the urgent need of opening a specialized centre to support children and adolescents who use psychoactive substances.

“We are in favour of building a modern centre that is capable of providing quality support to adolescents and is able to give parents verified and necessary information. This centre will become a model for working with adolescents from a key group as well as an educational and methodological centre for social pedagogues, juvenile inspectors and psychologists,” says Natalya Shumskaya, head of AFEW-Kyrgyzstan.

Taking into consideration that Kyrgyzstan’s culture is very traditional, there is a common misconception that people who use psychoactive substances are not good members of the society. This stigma leads to several issues. For example, teenagers are scared to talk with someone about the use of psychoactive substances. They are afraid of being expelled from the school or being suspected in crimes only due to their experience of using psychoactive substances.

“The center is also going to work on increasing the level of acceptance of psychoactive substances use among the society. This will lead to more effective support from the side of adults and to less risky behavior of adolescents as they got all proper information they need. It is the first step that can lead to final abstinence,” says Chinara Imankulova, manager of BtG project in AFEW-Kyrgyzstan.

AFEW-Kyrgyzstan specialists already developed a project of such centre. The centre will also work with those who have never used psychoactive substances and with children who are in high risk of starting using them. The prevention work will include helping teenagers to organize their leisure activity and to give them information that usage of psychoactive substances is not shameful, however it is important to ask yourself whether you are aware of the risks and if you really want to do so, to find solid information and to ask for help of professionals.

Creating the centre and the approval of the Comprehensive City Program will help thousands of teenagers to make healthy choices for a happy life.

We Fight, We Hide or We Unite

We Fight, We Hide or We Unite: coping strategies amongst resilient harm reduction organisations and community networks in the context of shrinking space for civil society in Eastern Europe and Central Asia

The title of this report, ‘We Fight, We Hide or We Unite’, reflects the survival strategies we identified amongst resilient harm reduction non-governmental organisations and community networks of people who use drugs (PWUD) in Eastern Europe and Central Asia (EECA). This assessment forms a part of the regional approach of the AFEW Network within the ‘Bridging the Gaps: health and rights of key populations’ programme, financed by the Ministry of Foreign Affairs of The Netherlands. This report presents the primary findings from the assessment, ‘Shrinking Space for Civil Society Organisations in Eastern Europe and Central Asia’, conducted between June and September 2017 at the international level by AFEW International and at the regional level.

We provide a detailed description of the overall study purpose, methodology, background and context regarding the shrinking civil society space and the coping strategies of HIV and PWUD CSOs working under these circumstances. The results of this assessment will be used to develop ideas and strategies on how to cope with the local contexts of the shrinking civil society space. In this way, it will contribute to the survival of CSOs and improving the current situation. This assessment represents the first step in the development of this focus within the AFEW Network’s regional approach within the ‘Bridging the Gaps’ programme. It will be followed by an analysis of existing gaps in the support necessary for specific interventions and initiatives to support specific coping strategies; the development of pilot projects on advocacy, service delivery or capacity building; and the continuous monitoring of results.

The full version of the report is available here.