Jean-Luc Martinage in Kiev
His name is Eduard. The 37-year-old man welcomes us with his mother Valentina in his old Soviet-style flat in the outskirts of the Ukrainian capital, Kiev. Eduard started using drugs when he was 20. It was not until 2005 that he found out about his HIV positive status through a routine blood test that was taken before having surgery.
Five years later, despite very serious surgery during which his lower jaw had to be removed, his health has been gradually improving. One contributing factor was surely the love and care provided by his mother, Valentina. However, there is also another Valentina who had a crucial impact in his recovery: the Ukrainian Red Cross trained nurse visiting him twice a week. Valentina is one of the 21 healthcare providers who is part of the joint project ‘HIV/AIDS and injecting drug use in Ukraine’ implemented in Kiev as well as two other cities by Ukrainian Red Cross with the support of the American, French and Italian Red Cross societies.
Visiting Eduard
Valentina Istratova has been a Red Cross nurse for 48 years. She has seen many changes including the fall of the Soviet Union and the rise of an independent Ukraine. But a major shift in her work happened in 2005 when she joined the HIV programme which was just starting.
Valentina visited Eduard for the first time in 2006. Since then, she has been visiting him twice a week, helping him take his medication, taking food parcels, providing psychosocial support to Eduard, and but if necessary, to family members to reduce stigma.
It is easy to feel the connection between the nurse and his client. Valentina encourages him to share all his concerns without having to leave things unsaid. Sometimes, Eduard reads her the poems that he writes. Over the months and years, Valentina managed to build trust with Eduard and his mother. “This is essential to the success of the programme since most people living with HIV are hiding their status from their neighbours and even sometimes from their relatives,” Valentina explains.
Surgery refused
Stigma and discrimination against people living with HIV is still high in Ukraine, all the more so since it also hits the health and care system. At first, when doctors learned that Eduard had been tested positive with HIV, they simply refused to do the surgery, although it finally took place at a later date.
Valentina believes that the Ukrainian Red Cross is playing a unique role of taking care of people living with HIV.
When asked whether or not she was a bit afraid to work with people living with HIV at the beginning, Valentina answers: “I am aware of the way the virus can be transmitted so I have no reason to be worried. It is so sad that some people can be so intolerant. We should do more to pass on information messages on the reality of HIV transmission, especially on television.”
Essential support
Visiting a nearby flat a few minutes later, we find another Red Cross nurse, Lyubov Rutkovskaya, waiting for us together with her client, a 38-year-old woman called Sveta.
When asked to tell us a little bit about her story, Sveta suddenly stops and bursts into tears, overwhelmed by the bad memories from the past. She finally finds the strength within herself to explain about the medical problems she is going through that left her partially disabled. She can no longer work which means financial difficulties for her family. So the support she receives from Lyubov is essential since the visiting nurse manages to bring her the medication that she cannot afford and also provides her with much needed psychosocial support.
A smile finally comes on Sveta’s face when she mentions her 16-year-old son. “He is so supportive,” she explains. “When I was tested positive with HIV, he immediately explained that I should not worry, that as long as I take the right medication and I follow a healthy diet, I can still live for many years. He had heard the true facts about HIV through a prevention programme at school, so it made things much better.”
In the afternoon, we drive to another part of town. This time, we meet with 38-year-old Oksana, who has been living with HIV for several years. “What keeps me alive is mainly the love I have for my three children,” she explains. One of them is handicapped, also living with HIV. Oksana Ladutko, the Red Cross nurse who visits her, provides care and treatment as well as psychosocial support. This is a much welcomed help when you think that her client was already refused a blood test in a clinic because of her HIV status and saw her medical record marked with a big ‘HIV positive’ written in red letters.
“I was still addicted to drugs when I received the first visit from the Red Cross. I owe them so much. I am still here very much thanks to my visiting nurse, really,” says Oksana. Since she spends most of her time at home, she became an artist, painting and also decorating masks that she likes to show to her visiting nurse.
Lack of funding
The HIV visiting nurses project is part of a much bigger programme that brings assistance to mostly poor and isolated elderly people, and is implemented by 3,200 Red Cross nurses reaching 450,000 clients throughout the country,” explains Alla Khabarova, executive director of the Ukrainian Red Cross Society. “We would like to extend our programme to reach more beneficiaries but lack of funding is a constraint.”
At the moment, 132 people benefit from the HIV visiting nurses programme, a much welcome support but which is still a drop in the ocean taking into account the severity of both the drug and HIV problem in Ukraine. According to UNAIDS statitistics, 360,000 people are living with HIV in the country, a number which could rise significantly if nothing is done to support the current efforts made by organizations like the Ukrainian Red Cross.