Against all odds: displaced woman living with HIV defends her rightsAug 7, 2017
Since the outbreak of the armed conflict in the eastern Ukraine and the events in Crimea more than three years ago, large-scale population movements were observed in the country. The UN office of the High Commissioner for Human Rights reports over 2 million displaced, including 1,2 million internally displaced persons. Estimates indicate that about 70% of the internally displaced people are women. Mass displacement led to a breakdown in the provision of basic services, affecting especially the most vulnerable.
Nelya, 37 years old, comes from the region of Donetsk, but had to relocate to the Kharkiv region after one morning she was hit by shelling when walking her son home from the kindergarten. “It was about half past six in the evening, and I was walking with my son and his friend from the kindergarten. The ceasefire had been announced at that time and kids continued their study in schools and kindergartens, – recalls Nelya. – Suddenly the shelling started. The first bomb shell forced me down to the ground. I grabbed the kids, pushed them under the concrete pile nearby and laid on top of them. Then I saw five more bomb shells coming”. Eighteen fragments of shrapnel were later extracted from Nelya’s body. Her eyesight was at risk after numerous operations later in Kharkiv. At the time of shelling, her only thought was to rescue the kids and not to lose her consciousness. This three-minute episode took place on 13 August 2014 and marked Nelya’s life before and after the bombing.
At the time of shelling, Nelya’s life was already not easy. A single mother with two kids and a factory worker, she had discovered four years earlier her HIV-positive status, which luckily had not transmitted to her children. Her relatives and friends supported her and Nelya was regularly taking pills within the course of antiretroviral therapy (ART) as it was prescribed to her in the local AIDS center to suppress the HIV viral load in her body. She took care of her health. “I had all I needed. Not much money, but enough to live a normal life together with my kids. But now we have no certainty about what to expect tomorrow and where to go…”
With support in Kharkiv city from a lawyer and social workers from NGO Positive women project supported by UNDP under the HIV Humanitarian initiative, the family moved out to Kharkiv since Nelya needed specific medical assistance. She and her kids lived in the former kids’ camp “Romashka” together with other internally displaced people (IDPs). When other camp dwellers found out about Nelya’s HIV status from TV news (Nelya agreed to reveal her HIV status to journalists), the family was requested to leave the IDP shelter. To protect her rights, Nelya had to seek legal support from the UNDP-funded Positive Women initiative.
In addition to housing problems, Nelya also had numerous denials from different medical hospitals in Kharkiv that found various reasons to deny her the eye surgery she needed badly: Nelya was at risk of losing her eyesight due to the head trauma during the bombing. Their reasoning was they could not conduct an eye surgery of an HIV positive woman.
The local NGO that helped Nelya to move from Donetsk to Kharkiv, helped her to register in Kharkiv AIDS center where she continued receiving ART, they provided social supervision and legal support to get her registered as IDP. She also received the status of a disabled person. Finally, the NGO helped Nelya to receive the surgery she required.
Within the HIV Humanitarian response program introduced by UNDP in 2015, the ongoing AIDS National Hotline program is monitoring violation of rights of the PLWH (people living with HIV) displaced from the conflict affected zone to other regions of Ukraine. UNDP assessment of displaced women revealed that women are at risk of their rights being violated, considering the hard economic situation and their increased potential exposure to domestic and/or armed violence, survival sex or trafficking. There is an increase in the level of prostitution in the armed conflict area because of a large military presence and population that is desperate for financial resources. UNAIDS reports HIV incidence is on the rise in these areas.
Due to the conflict, health conditions and access to health services have been hampered through limited access to affordable health care and the fact that those health care facilities that are in government controlled areas (GCA) are now having to cater for both the natural, pre-conflict population living in these rayons as well those IDPs who have had to relocate from non-government controlled areas (NGCA). Transport logistics of emergency medical care was completely disrupted due to the reduction of the number of health care facilities. There is a lack of tertiary hospital care as these medical facilities are located in the cities of Donetsk and Luhansk in the NGCA. This is causing a lot of problems for people who need specialized medical treatment since two local hospitals are not always able to meet the needs of the referred cases (See detailed report). PLWHIV seek medical assistance in the neighboring Kharkiv and Dnipro regions.
UNDP coordinates activities on protection of the rights of HIV positive women and girls, counteracting the gender based violence and empowering the IDPs belonging to HIV-vulnerable populations. Since 2015, UNDP in Ukraine is supporting HIV humanitarian response in Ukraine. The main goal of this initiative is to monitor the human rights violations faced by internally displaced PLWHIV by using formative assessment, existing national and regional online monitoring systems, national HIV hotline 0-800-500-451, and providing legal assistance and social support to internally displaced population and PLWHIV with focus on women and girls. As a result of these activities, about 9,000 IDPs with HIV and most-at-risk groups were informed on their rights and legal support opportunity; 1,563 targeted clients got direct legal assistance with more than 1,700 consultations.
Over the last few years, in partnership with NGO “Positive women”, UNDP in Ukraine provides assistance to the HIV-positive women and the women belonging to HIV-vulnerable populations. A legal and social aid network was supported to carry out grass root work in the regions overcrowded with IDPs over 2015-2016 with a focus on aid for HIV positive women. In 2016 the NGO Positive women provided gender specific social and legal aid for around 300 HIV positive and displaced women in 6 regions of Ukraine. In 2017, the UNDP program is focused on supporting HIV positive women, women from most-at-risk groups as well as those who experienced gender-based violence in the GCA in Donetsk and Lugansk regions.
As of 1 January 2017, according to Public Health Center of the Ministry of Health of Ukraine there were 1614 IDPs with HIV status including 784 women, who were referred for medical assistance.