Зеличенко Александр Леонидович : другие произведения.

Half of Hiv-infected in Kyrgyzstan found in prisons

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   Half of HIV-infected in Kyrgyzstan found in prisons
  
   Ten victims a minute is the rate at which the killing
   epidemic hits the world, as Kyrgyz Deputy Health Minister, Madamin
   Karatayev, told Cabinet members, representatives of various state agencies,
   international agencies, and non-governmental organizations (NGOs) at the
   roundtable "Harm reduction of from drug usage in the penitentiary
   system of Kyrgyzstan".
  
   "The uncontrollable spread of tuberculosis, HIV/AIDS, and hepatitis in
   prisons may lead to a catastrophe," said the deputy minister. And since
   HIV and hepatitis C, for example, normally travel by needle in a rather
   populous drug-using segment of the prison population, the discussion -
   straight and open, importantly - was mainly devoted to drug-related
   problems. Such a format of the meeting was possible because all the
   participants were provided with the handouts of the survey, initiated by the
   Central Asian Republics HIV/AIDS Program (CARHAP) and conducted by the
   author in the institutions of the Central Execution Department in
   December 2005 - January 2006.
  
   Recent riots in prisons proved the need for urgency of reforms in the
   execution service. On March 10, the government approved the National
   Program "Umut" (Hope) for the period up to 2010 on restructuring of the
   penitentiary system in the Kyrgyz Republic. The Justice Minister Marat
   Kaiypov presented the program. Based on best international practices, the
   program aims at legislative enhancement, ensuring human rights - even
   behind bars, improvement of detention conditions, guarantees to
   prisoners of medical care and social rehabilitation.
  
   Also discussed were such hot issues as development and application of
   alternative punishment, demilitarization of the penitentiary system and
   staff training, interaction with the civil society, international
   cooperation, and research activities. The program specifies the terms of
   execution with regard to women and minors, and offers practical measures
   on improving the daily routine, supervision and safekeeping of convicts.
  
   The minister paid special attention to the growing prison population.
   Today, it exceeds 16,000, while there were as many as 8,000 prisoners in
   2000. The amnesties declared almost every year, rather than save the
   game, point to the weakness of the legislative base. Reluctant to think
   of proper alternative decisions, judges keep incarcerating people. Of
   all the countless examples, the most illustrative one is the 2005 case
   where a woman arrested for 0.28 gram of heroin was sentenced and -
   despite her late pregnancy, the defense's and attorney's appeals - sent to
   prison for three years. On her third day there, she gave birth to a girl.
   Five months later, the baby had no birth certificate and still
   unvaccinated, was - for all medical care - at permanent risk of infections, as
   she was living together with her mother in one of the medical unit's
   rooms.
  
   The roundtable focused on preventive measures. More than half of the
   826 infected were found in prisons, as the blood testing on entry to the
   institutions showed. At present, prisons and pre-trial detention
   centers have 131 such patients, who often have to conceal their status.
   Adequate treatment is available to those in need, as well as the
   antiretroviral therapy.
  
   In the majority of prisons, despite all locks and bars, drugs
   eventually reach the convicts (not without corruption!). Such factors as
   overcrowded prisons, lack of syringes and sterile needles doubles the damage:
   one single virus carrier means tens of infected IDUs (intravenous drug
   users). It's now been three years since prisons introduced syringe
   exchange systems and increasingly popular HIV education programs. No fresh
   cases have been registered among the syringe exchange program
   participants. Isn't this an argument for "harm reduction"?
  
   Many prisoners favored the rehabilitation center Atlantis whose
   branches help those having passed a thorough screening to participate in
   psychological programs for alcohol and drug abstinence. In turn, Atlantis
   passed a life test: most of its clients quit drugs for six months and
   longer. Medical specialists call it stable remission. Due to insufficient
   funds, the program covers only two prisons so far, with many more to be
   covered in future, though.
  
   Officially, every seventeenth convict, under a court decision, must
   take a mandatory anti-alcohol and anti-drug course. Actually, the numbers
   are much higher. However, a regular prisoner who hasn't completed the
   treatment may not hope for parole (early release). This is what makes
   them keep in secret their addiction.
  
   At the same time, those who were forced to take a course, complain
   about the lack of systematic approach. In the words of patients, treatment
   starts only after the meeting with a consulting narcologist. And the
   latter never comes soon. In one of the institutions, the corrupt practice
   required prisoners to pay 300 soms to invite an expert. Moreover, the
   treatment itself is ineffective, being reduced to heart-to-heart talks
   with the medical staff, vitamin therapy, and droppers. The institution
   having no full-time narcologist in its medical unit has to invite one
   every time from the city center. And the specialists refuse to consult
   convicts free of charge. As a result, the period from the moment of
   entering an institution till the beginning of treatment may last up to half
   a year.
  
   In any case, enforced treatment cannot be effective by definition.
   Furthermore, adding to its ineffectiveness is the absence of modern
   techniques, skillful personnel, and necessary medicines. Therefore, based on
   personal experience and the survey results, the roundtable participants
   made recommendations to revise the respective part of national
   legislation.
  
   A number of other interesting proposals were advanced, including that
   on the need to closely cooperate with courts, to educate judges on
   up-to-date approaches. The representatives of the UN program on drugs and
   crimes promised to find money for this purpose.
  
   No less interesting were ideas proposed by the head of the governmental
   sector on coordination of HIV/AIDS activities Ainagul Isakova. For
   example, she suggested that NGOs should sign contracts with the Central
   Execution Department for a certain harm reduction action in a specific
   institution. In this case, she believes, each of them will be covered with
   a "prophylactic umbrella".
  
   The conclusion unanimously made by all the debaters is: to rely on
   donors and NGOs only is not enough. The Central Execution Department in
   general, and its medical and preventive programs in particular, will not
   survive without real governmental support.
  
  
   Alexander Zelichenko, International Drugs Policy Expert, Police colonel.
   Bishkek, Kyrgyzstan
  
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