More than 390 refugee and IDP OST patients from the Crimea and the ATO area can continue the life-saving treatment!
The Alliance of Public Health (the Alliance) completed the humanitarian project on support of the OST patients – refugees from the Crimea and internally displaced persons from the ATO area, which had been funded by the international organizations for more than 2 years. From May 2014 to June 30, 2016 more than 390 opioid substitution therapy (OST) patients being the refugees from the Crimea and the ATO area, were able not only to relocate in the safe regions of Ukraine, but continue the life-saving treatment and start over again at the new place. (Based on the survey results, 95% of the clients after the completion of the project are planning to stay in their new places of residence and receive OST services on general conditions.
The essence of OST as drug dependence treatment is that a patient regularly takes an OST drug under doctor’s control, being able to quit criminal activities, find a job, improve their health, fully integrate into the society. Currently there are 8,152 OST patients in Ukraine. Before the occupation of the Crimea and a part of Donbas there were about two thousand persons on treatment, and only a third of them was able to continue the treatment on non-occupied territories. Others were deprived of this opportunity, having their life and health threatened. Based on the data by the UN Secretary-General’s Special Envoy Michel Kazatchkine, after OST program discontinuation in the Crimea about 100 patients died, official statistics for the uncontrolled territory of Donbas is not available, but the patients’ situation there is no better.
The Alliance had always held the protection of OST patients’ interests as a cornerstone of its activities and in this critical situation launched active advocacy, awareness and fundraising campaign to protect their rights, laying the foundation for the humanitarian project. The patients were offered to relocate to one of 16 cities in 8 oblasts where they were able not only to continue treatment, but obtain an interim 24-hour social support to help them adapt at a new place, which included the payment for accommodation rental at the expense of the project, organization of meals and providing for household needs, assistance with employment, obtaining documents, etc. Considering that the majority of OST patients are persons with severe chronic diseases, the uninterrupted treatment was ensured for HIV, TB, or, if necessary, the possibility of medical examination and timely prescription of treatment for these diseases.
Oleksandr, OST patient from Horlivka, who is now living in Kramatorsk, tells, “We knew that the drug stock is running low, but then out of a sudden they brought us together and said that the site is closing. OST hotline told me that there is a possibility to relocate, thus I contacted the project coordinator and moved to Kramatorsk. I like this city, they rented me a comfortable apartment and were always ready to help. It’s hard to believe, but while this seems an ordinary city, even the sun is brighter here, there is a friendlier environment of sorts… I have pity for those who stayed on the occupied territory. People understand that they were not right, but not everybody would dare to leave. I was lucky enough…”
From the very beginning the project aimed not only to support the patients in the first months after relocation, but comprehensively facilitate their integration in the local communities. As the result, 99% of the project clients were registered as IDPs and receiving the governmental allowance, 19% were receiving disability allowance, 5% received childcare support. As of the moment of project completion 41% of patients have full-time or temporary jobs helping them to pay for accommodation on their own after the project completion.
According to the project participants currently residing in Dnipro, “The assistance program organized by the Alliance allowed us to survive and adapt in the new unfamiliar city. At this stage of our life we were not left alone, Alliance staff was helping us so much, that’s why we successfully started adapting to the life in the new city rather than sink into despair”.
The Alliance aimed to achieve the sustainability of services even after the completion of the project funding, that’s why key attention was paid to seven healthcare facilities, on the basis of which OST services were provided on the controlled territory of Luhansk and Donetsk oblasts (Slovyansk, Kramatorsk, Mariupol, Krasnoarmiysk, Lysychansk, Severodonetsk, Rubizhne), because they were the most demanded by the relocated persons, concentrating 51% of all project clients. The project budget funded the procurement of equipment, repairs of the site premises which allowed, among other things, to open the new OST cabinet in Rubizhne city where as of the moment of project completion 44 OST patients were serviced, including 6 IDPs.
Meanwhile… On June 23, 2016 the treatment on the uncontrolled territory of Donetk and Luhansk oblasts was completely discontinued. Due to depletion of the stock of drugs the last OST site which had still been functioning in Donetsk got closed. 23 HIV-positive patients for the last time received a minimal dose of methadone (5 mg). Not everybody managed to relocate on the territory controlled by Ukraine to continue treatment, the majority faced harsher fate. Based on the information available to the Alliance, during the involuntary decrease of OST dosage 20 patients, most of them HIV-positive, died in Donetsk only. This further emphasizes the importance of the project implemented by the Alliance, as it was saving lives rather than just simply providing treatment.
The project was a challenge for the Alliance, because it was quite unique. According to Tamara Tretska, project manager, “It was a complicated project. Many activities were developed and changed in the course of the project. Sometimes we had to start virtually from zero; we had to provide patients with clothes, footwear and other necessary items, because the first patients from the ATO area sometimes arrived without any possessions, having just escaped the bombing. Due to successful cooperation with the healthcare facility managers and OST doctors we could promptly solve the issues of admitting the patients who often had no medical documentation with them. We greatly respect the doctors’ attitude, who treated the clients as first and foremost people in need of help. There were no refusals to admit patients. However, all the difficulties and barriers the project team had to overcome are fully rewarded, when we realize that we were able to fully change people’s lives, and did not abandon the patients, making them face all the problems of therapy interruption on their own. The patients had a real possibility to fit in the new conditions”.
Reference: the project for the support of OST patients who were refugees from the Crimea or IDPs from the ATO area was funded by different donors:
· International Renaissance foundation (08.05.2014 – 31.03.2015)
· Elton John Foundation(1.10.2014 – 25.12.2014)
· Pompidou Group of the Council of Europe (1.02.2015 – 31.05.2015)
· Global Fund to Fight AIDS, Tuberculosis and Malaria (1.06.2015 – 30.06.2016).
The total amount of funding exceeded USD 750,000