Invitation to participate in the Tender for the selection of Editors

Eurasian harm reduction Association (further EHRA) announces a tender for the selection of editors for a long-term cooperation with EHRA.

Based on the results of the tender, EHRA will select several consultants, with whom EHRA will conclude long-term contracts.

More information about the Association and specifics of the work you can find on our website http://harmreductioneurasia.org

Type and subject of the tender:

As part of its work, EHRA requires quality editing and proofreading of various types of documents, reports and publications:

in English language,

in Russian language.

As a result of the tender, consultants with the highest amount of points for each of the following category of work will be chosen:

– (ER) editing texts in Russian language,

– (EE) editing texts in English language.

Requirements to participants of the tender / evaluation criteria:

Essential requirement for the participants of the contest:

– Category (ER) – the Russian language must be native to the candidate (native speaker);

– Category (EE) – the English language must be native to the candidate (native speaker).

General requirements for the participants of the contest.

To assess the tender applications, the following criteria will be used (maximum amount of points for each criterion):

  • Experience of editing in the fields of public health, human rights, harm reduction etc. – maximum 20 points.
  • Quality of the completed test task – maximum 50 points.

Text for Category (ER)

Text for Category (EE)

  • Education: diploma in linguistics, philology or other related fields; special certifications, etc.: maximum 20 points.
  • Price of editing of a page of text (1800 characters with spaces) maximum 10 points.

The maximum possible amount of points            100 points

Participants must submit:

  1. A cover letter in a free format (no more than in 1 pages), which should include:
  • information for which category of work (ER, EE) the documents are submitted;
  • indication of the cost of services, i.e. editing of a page of text in EURO (1800 characters with spaces);
  1. Completed test task in Word-format (.doc, .docx).
  2. CV in a free format;
  3. Copies of diplomas and certificates, as well as links on the examples of the previous editing.

ATTENTION! If these documents are not provided in full, such application in not considered for evaluation.

Application deadline – 1 p.m., September 30, 2019, Vilnius local time. Please send your documents at julia@harmreductioneurasia.org

Special conditions:

Upon the completion of the tender procedures, EHRA will sign long-term contracts with the selected number of Consultants on a fixed cost of services per unit basis in EURO (page of text, 1800 characters with spaces). Further work will be carried out based on the needs of EHRA and according to the timeline and other conditions, which will be decided upon in each individual case.

The submission of documents for participation in the tender does not impose on EHRA any additional obligation to conclude a contract.

Mari Chokheli, Chair of the Steering Committee of EHRA: “We often talk about the “community” and “experts.” In five years, I would like to see a strong community of experts, who defend their rights and engage in all the decision-making processes. I would like to make it real, not just a slogan or a formality.”

EHRA presents a series of conversations with people whose names and roles in harm reduction are well known in the region of Central and Eastern Europe and Central Asia, and beyond. They will share with us the most valuable – their experiences, thoughts, memories.

Marina (Mari) Chokheli is the Chair of the Steering Committee of the Eurasian Harm Reduction Association (EHRA) and Coordinator of Harm Reduction and Access to Medicine Programs, Open Society Georgia Foundation (OSGF). She has been working for OSGF since 2010 and actively engaged in various areas related to public health, harm reduction and access to Medicines: community mobilization; strengthening and capacity building of community organizations and activists, promoting human rights of vulnerable groups; drug policy and promoting humane and efficient law enforcement policies and practices affecting vulnerable groups; advocating, developing and launching of the first National Hepatitis C treatment programs in Prison and for general population in Georgia.

And what’s more, she is an amazingly sincere, attentive and responsive person.

Mari, when and how did you come to work in harm reduction?

– (Smiling) Sometimes you do not even feel as time goes by. It has been a long time, about twelve years ago. I worked in human rights sphere and often interacted with PUD living with HIV who stayed in places of confinement. They needed methadone programs and access to treatment. Even back then I realized that harm reduction is not just about the right to health, it is an integral part of the rights of all people (though we still have to prove it in many countries of our region). I started searching for information, subscribed to the regional ITPC mailing list. Though it was focused on HIV, it also contained discussions on the strategic litigation in the European Court of Human Rights, in particular on access to medical services.

Now, thanks to social media, finding information is not a problem, but then you could only look through mailing lists and websites. Nothing else. Needless to say, I did not know about any organizations working in harm reduction in Georgia. I met them later, through different conferences and international networking events. That was my first experience.

Did you have a chance to work in a national harm reduction organization in Georgia?

– I worked with court proceedings, strategic litigation, dealt with constitutional cases, in particular those which further went to the European Court of Human Rights. As soon as I changed the area of my activities, I saw a relevant vacancy in the Open Society Georgia Foundation. In fact, I had several job offers, but I chose OSGF as it is a place where you always remain an activist. Sure, there is a strategy, there is a certain structure, but still you are free in your planning, you are involved in processes at all levels, you work directly with activists and learn about the relevant needs and issues first-hand from them. Besides, in OSGF there are opportunities to learn and gain experience. If you want to suggest something new and innovative within or beyond the existing strategy – you are welcome! It is a very favorable environment. 

Sometimes we pilot projects with no significant resources: we initiate those projects and strive to make a certain problem visible, mobilize activists and resources to solve it. Gradually, other people join us, we have more allies, we raise funding. That is when we can step aside. When you work in OSGF, you are not just a donor, who only reads reports, plans strategies and announces calls for proposals. You are involved in all the processes from planning to implementation.

Do you still work there?

– Yes, I am a Coordinator of Harm Reduction and Access to Medicine Programs.

Great! Mari, taking into account your workload, we are especially glad to see you as the Chair of the EHRA Steering Committee! How did your relations with the Association develop?

– I have an extensive experience of working with EHRA. Our roads often crossed, sometimes even not within a particular project, but within different initiatives. There are many creative ideas in our region. I like it when you have some idea at your country level and EHRA already develops the same idea at the regional level.

Could you give an example, please.

– Maybe because I come from the human rights sphere, I have always thought that building partner relations between human rights organizations and harm reduction organizations (first of all at the local level) is kind of a cornerstone. So we continued this work, also in the area of strategic litigation. It really helped us to make a few steps ahead. Firstly, because we had more supporters. Secondly, because with the same advocacy efforts strategically you prove to the state that it is mistaken, that it violates your rights. Thus, you manage to achieve systematic changes at the precedent level.

So we raised the issue of advocacy. In your opinion, how different is this process at the national and regional levels?

– It is a difficult question. On the one hand, each country has its peculiarities and specificities. The approach that works in Georgia could fail in another country, and vice versa. On the other hand, regional advocacy campaigns often make your position stronger and help you to further plan your activities. When the messages relevant to your country are presented under a common “umbrella,” it makes them stronger!

What is also important is that at the national level you focus on your own experience, knowledge, resources (in particular, intellectual resources). At the regional level, you also embrace other people’s experience – both positive and negative. After analyzing this information, you go to implementation. When we had tenders for the Hepatitis C program in Georgia, we in OSGF learned from our Ukrainian colleagues how they plan such procedures in their country and we also cooperated with the Egyptian activists, who wrote a similar program and have already done something like what we were doing. We were equipped with information, which greatly influenced the outcome. Regional advocacy is not easy, but it is very strong!

You said the work “campaign.” Last year, at the International AIDS Conference in Amsterdam there was a campaign initiated by the key populations networks from EECA called ‘Chase the Virus, not People!’ Why do you think such advocacy activities are important and do you think this campaign should be continued?

– This campaign showed itself, its goal is vital. Regional campaigns are very important in general, especially in the context of countries transitioning to domestic funding. The only thing I would consider is that, when we develop advocacy messages, we should try to make them clear not only to us, not only to those who work in harm reduction, but also to people who are, let’s say, out of this topic: economists, lawyers, politicians, etc. Everyone! This is what I would consider in future. Unfortunately, there are very few examples in countries or regions, where the message would cover all the population, touching the hearts of various people.

Is it important for the community networks to cooperate in such a format?

– Sure, of course! It took us a long time to reach common ground, but leaving behind some nuances, we all have one goal – to survive and live full lives! That is why I think it is important for us to unite within such campaigns and networks. Our voice is to be heard.

We are having this conversation within the EHRA five-year strategic planning meeting. That is why I have two questions to you. What objectives set forth in the previous strategy did EHRA achieve and what it did not? And what should be included into the new strategy?

– During this meeting, we had a lot of discussions with the EHRA Steering Committee and Secretariat – not only about our achievements, but also about the things we failed to achieve. I think it is a right approach, when, planning your future, you analyze and take into account all the lessons learnt. The work that we did was not easy.  Transformation of the Association was a crucial task. I am glad to say that it was a success as well as our regional advocacy. EHRA clearly realized the goals and needs of every country, helping to bridge the gaps. Gradually, strengthening the community, conducting assessments, overcoming barriers and analyzing what works well led to the next step – advocacy, specifically advocacy together with the community. This is what we have been doing and I would surely continue these efforts.

As for our next mission, I believe that it should be very ambitious, even cosmic! When you go beyond what you think is real, you achieve more. In my work, I often follow the rule: “Plan as much as possible to get what you want.”

“We often talk about the “community” and “experts.” In five years, I would like to see a strong community of experts, who defend their rights and engage in all the decision-making processes. I would like to make it real, not just a slogan or a formality.” It depends not only on funding – programs can be implemented even with fewer resources. We have learned something, we already have some knowledge. The main thing is providing access to quality services. Everything should be based on the vital needs. I will give an example: in most countries, naloxone nasal spray is not available, while injecting naloxone is sold by prescriptions, and we are talking about the medicine used in case of overdoses and which save lives!

What does harm reduction mean to you?

– For me, harm reduction means that a person should have everything he or she needs to stay safe, to stay alive, with the feeling of dignity and all human rights. Harm reduction is a program, which is always aimed at risk reduction and care, though it may change depending on the drug scene and the situation in society, on the new psychoactive substances appearing, etc. However, the basic harm reduction package should be: a) needs-based, b) individual.

Mari, with the schedule you have

– (Laughing) I have none!  Working at the weekend and exchanging emails with colleagues at 3 a.m. is my usual routine. But I am lucky: I spend my whole life where I want to be, I wake up in the morning – and I am happy to go to work, meet new people, learn new things, and do what brings me moral satisfaction. My work is more than just complying with my job description.

So your work is your lifestyle? How do you manage not to burn out?

– The best way to relax for me is going to the mountains for a couple of days. Turning my phone and internet off. When I look at the nature, look at those magnificent mountains, all my problems seem so tiny… It is a great feeling! You re-assess everything. All your troubles, all the things inside you that you are not happy with – it all goes away. Even if I stay in the mountains for just three days, I have a feeling that I had a four-week vacation. My strength comes back to me, the puzzle in my head puts together, and I can clearly see my priorities. Mountains help me to stay true to myself. No matter what.

EHRA submitted report to the UN Committee on Civil and Political Rights for the adoption of lists of issues on Ukraine

On the 30th of August, 2019 EHRA together with Canadian HIV/AIDS Legal Network and Charitable Organization «Charitable Fund «Ukrainian Network of People who Use Drugs» (VOLNA) submitted the report to the 127th session of the UN Committee on Civil and Political Rights for the adoption of lists of issues on Ukraine. The report draws the Committee’s attention to the Violations of Articles 2, 7, 9 and 10 of the International Covenant on Civil and Political Rights as part of drug enforcement in Ukraine.

In 2018, every seventh person convicted in Ukraine (10,144 of 73,659 people convicted of criminal offences) was convicted of drug crimes; of those, 8,513 people (84%), were convicted of crimes of simple possession for personal use (Article 309 of the Criminal Code); of those, 6,482 (76%) were convicted for possession of narcotics in miniscule amounts that ranged from 0.005 to 1.00 gram of heroin.[1] People who use drugs and especially people who live with drug dependence are vulnerable to discrimination based on this chronic health condition, arbitrary arrest and ill-treatment by police. When people with drug dependence are criminally prosecuted for possession of small amounts of narcotic drugs for personal use, this amounts to detention solely on the basis of drug use or drug dependence.

According to the 2019 Report of the UN High Commissioner for Human Rights, people who use drugs face an increased risk of torture and ill-treatment [in detention]. In some cases, law enforcement officials deliberately take advantage of the pain and suffering associated with withdrawal syndrome elicit forced confessions while people who use drugs are deprived of their liberty. Human rights mechanisms concluded that the use of withdrawal symptoms to obtain information or confessions, to punish or to intimidate or coerce may amount to torture.[2]

Suggested items for the List of Issues with respect to Ukraine

  • Please provide information about measures the State Party has adopted to protect people with chronic drug dependence from discrimination and ill-treatment, taking into account tough drug laws and high rates of criminalization of people who use drugs in Ukraine.
  • Please provide information about measures the State Party has adopted to ensure access of prisoners with drug dependence and HIV to essential medicines and HIV prevention services that are equivalent to those available in the community.

 

[1] Official courts’ statistics for 2018. Online: https://court.gov.ua/inshe/sudova_statystyka/rik_2018

[2] Human rights in the administration of justice. Report of the United Nations High Commissioner for Human Rights. A/HRC/42/20. 30 July 2019. Para 6.

Terms Of Reference For Development of “Chase the Virus, Not People!” National Campaigns

Eurasian Harm Reduction Association (EHRA) is looking for national partners (country consortia, NGOs, community organizations and initiative groups) to develop and implement the CHASE THE VIRUS, NOT PEOPLE! campaign at the national level in 3 countries of the Eastern Europe and Central Asia region.

The assignment is implemented in the framework of the Eurasian Regional Consortium project “Thinking outside the box: overcoming challenges in community advocacy for sustainable and high-quality HIV services”, funded by the Robert Carr civil society Networks’ Fund.

Campaign was launched at AIDS2018 in Amsterdam, the Netherlands, in July 2018. The regional communities’ networks, who joined forces in the campaign represent key populations affected by HIV: people living with HIV, women living with HIV, youth and teenagers, affected by HIV, people who use drugs, sex workers, men who have sex with men, trans people. The campaign emphasized the common needs of all key population groups and focuses on overcoming the discrimination, stigmatization and criminalization of key populations as a key condition for an effective response to the HIV epidemic in EECA countries.

Aim of the campaign:

To strengthen the voice and influence of national activists at the national level in articulating their advocacy priorities and drawing the attention of target audiences to the problems of key populations in relation to the catastrophic HIV/AIDS epidemic in the EECA region, in particular the impact of stigma, discrimination and criminalization on effective response measures to HIV/AIDS epidemic and mortality reduction.

THE TERMS OF REFERENCE ASSIGNMENT

TASK:

to develop and implement the national campaign under the slogan “Chase the virus, not people!” with specific advocacy objectives in the framework of the regional campaign.

EHRA is issuing 3 grants in 3 countries accordingly to the winners in the open competition (NGO, community organization or initiative groups).

AIM (sample, to be adjusted per country needs):

To strengthen partnerships between national key populations organizations and activists to draw attention of key steakholders and decision makers to the impact of stigma, discrimination and criminalization on effective response measures to HIV/AIDS epidemic and mortality reduction in the country

Grant sum – 2,000 Euro per country.

EHRA technical support – EHRA representative’s participation in development of the national campaign (country visit for 1-day mentorship session; on-line technical support to the national campaign organizer).

Terms of project realization – till the end of 2019.

REQUIREMENTS FOR APPLICANTS:

  • Be registered in one of the countries of the Eastern Europe and Central Asia region;
  • Work with/represent/provide services/advocate for the needs of key populations on the national level;
  • Share the aim and objectives of the regional campaign “Chase the virus, not people!”;
  • Describe the problem statement for advocacy within the national campaign;
  • Identify the goal of the national campaign;
  • Demostrate the previous experience in realization of advocacy/communication campaigns (if any).

To apply for the assignment the organization or individual has to submit to natalia@harmreductioneurasia.org till COB September 20, 2019 the following documents:

Description of the organizational experience to follow the above described requirements,

Letter of interest (not less than 500 words and not more than 1500 words),

Timeline of campaign development and implementation with the brief description of stages and terms.

The submitted applications will be evaluated by the selection committee of the Eurasian Regional Consortium. The following criteria will be used to evaluate the bids (the maximum possible number of points is 100):

  • Work experience with key populations (20);
  • Problem statement (20);
  • Clear and achievable goal of the campaign (30);
  • Realistic and clear timeline of the campaign (30).

Before submission of the application, please read carefully ToR for national partners.

The Magic Bracelet

Author: Olga Belyaeva, Advocacy Manager, EHRA

When I heard someone knocking on my hotel room’s door and shouting “She is dying!!!” I was in the bathroom. Just five minutes ago, I entered my room, took my coat and shoes off and… ran out straight away with Naloxone.

After that memorable meeting in Scotland, I carry it with me all the time.  

Glasgow. July 2018. My 45th birthday. “You know, we have a very serious problem with overdoses – those were almost the first words I heard from Stephen Malloy, part of the team of the European Network of People Who Use Drugs. I nodded and a routine though came across my mind: “Back at home, in Vilnius, up to 12 people are found dead in bad months. Under the guise of heroin, people are sold a mix of morphine and methadone together with fentanyl.”   

Looking at me attentively, Stephen went on: “My country has done very well with offering OST (methadone, buprenorphine) but everyone knows more MUST be done. People need easy access and doses that are suitable to them. There will be a small ‘Heroin Assisted Treatment’ program beginning in September 2019. and in time, if it is allowed to grow, it will change so many lives for the better; IT WILL SAVE LIVES.”

So here it is,” Stephen was holding an oblong narrow yellow box in his hand. “Are you ready to take it with you?”  I recognized it: once I saw such a box at a conference. It was convenient and stylish, with Naloxone inside. I said “Sure!” and took the box. “Then put this bracelet on. People will know that you have naloxone with you, if you overdose and they find you. They will be able to help you and you will be able to help others.”  Stephen watched me carefully, assessing my decision: was I really ready?

I put the bracelet on, found a place for the Naloxone box in my belt bag, where I already had my wallet, my phone and my beads. Then I continued my three-day work at the meetings on overdose response.

One of the meetings was dedicated to the topic of 48 hours after prison. There was a discussion with the experts in overdose theory on what should be done first: Naloxone injection and then artificial respiration or first artificial respiration and then Naloxone? My logic told me that first Naloxone is to be injected, which will help to ensure artificial respiration. “That’s a question of life, so it needs a correct answer. When I go to Ukraine, I will have to go and visit Vasiliy, he is an emergency doctor in the city of Dnepr. He saved my life more than once, so I believed him. He will tell what is to be done. He will also teach me how to do it,” I was thinking, packing my things to go to the EHRA headquarters in Vilnius.

Railway station. Stephen and Nicole’s birthday present – Scottish red and green check scarf – kept me warm. Standing at the platform, we gave each other goodbye hugs, listening to our heartbeats.  Making myself comfortable in my seat with a book, I realized that my eyes were constantly coming back to the yellow bracelet.  The sounds of the train, its rhythmic swing combined with polite and quiet travel companions – it all gave me a chance to think why it happened like this: I had 30 years of opoiod use behind me, but Naloxone became part of the things I always consciously carry with me only three days ago.

Why? With the daily use of opiates, which were cooked correctly using high-quality materials, overdoses were rare in our group. Usually they happened after the forced “treatments.” Since about 2005, if you hear someone had an overdose in Dnepr (Ukraine), the response would be: “He was lucky to survive.” Naloxone ampules were available in mobile clinics and from outreach workers since 2003. However, it was the first time in my life when I wore a bracelet saying “I have Naloxone.” We always tried to avoid carrying Naloxone ampules with us so that the police would not start working on us because of it: “Hey, Naloxone, so you’re a drug addict!” Then the standard scenario would follow: taking a bribe and letting us go for a while. Another scenario could be turning the life of the person and the family upside down, if they needed to show better “crime detection rate.” Quietly and invisibly, the bracelet started raising my level of consciousness about overdoses.  It became a part of me. I only take it off when I have my aikido practice. The rest of the time, I have the bracelet on my arm, which means I have Naloxone in my bag and my bag – on my belt.

The approach to have Naloxone “always at hand” helped me to save a person’s life at the hotel. I covered three floors – and 40 seconds after I heard someone knocking on my door, Naloxone was already doing its work in the body and helped us to keep our dear friend alive. We did artificial respiration, poured water, and our team of two people + naloxone helped to save our friend’s life. We prayed for Stephen and Nicole. I realized that I do not have practical reanimation skills, which work automatically. At the same time, wearing a bracelet saying “I have Naloxone” means that I have to be 100% sure about the things I am doing. So I still had the question: what should come first – Naloxone or artificial respiration? My trip to Dnepr was not coming soon, but the question was vital. So we invited a practitioner, an emergency care doctor to come to the EHRA office, share his experience and tell us what to do.

“After death, pinned pupils are seen only in people who died of opiate overdose. Sometimes it can also be an effect of cerebral hemorrhage, but in this case one pupil is constricted and the other is not,” told us an emergency care doctor from Vilnius. That is how easy it is to collect data and see how many people actually die of opiate overdose, who those people and their family members are and what can be done. Those are the things to be done:

First, 70% of people die as they are not able to breathe. When a person is unconscious, his tongue base goes down and closes the air passages.  What to do: put your hand on the person’s forehead, throw the head a little back and put the jaw down. Often you will hear a deep breath.  There are three ways to determine if the person is breathing: eye, ear next to the person’s mouth and watching the person’s chest. With your eye, you will always feel the air moving, with your ears you will hear it and the chest will help you to see it. A person makes 14-16 breaths per minute. So we wait for 10-15 seconds to see if we can hear or feel the person breathing or see the chest moving.

Second, we must fill the lungs with oxygen. “While an amputated limb or finger can be stitched back to the body even after three hours, a brain cell left without oxygen for four minutes, dies and this process is irreversible.” We breathe in 21% of oxygen, breathe out – 17%. So that’s what we need to do straight away: hold the nose and carefully breathe the air into the person’s lungs twice. This air will be enough to save the brain so that we have four minutes to inject Naloxone and ensure artificial respiration.

Third, make an intramuscular injection of Naloxone.

Fourth, artificial respiration: we press the chest 30 times and let go, going 4-6 centimeters deep, while breathing. You can watch the practical learning session by the emergency care doctor.

…Summer 2019. “Thank you, Stephen. Girls from the Narcofeminist movement and your Naloxone saved my friend’s life. As for the bracelet, it is a magic one. It helped me realize that I need to develop my skills to help people in different overdose scenarios.” When we met at the Harm Reduction International conference in Porto, we hugged each other tightly, not letting go for a while. 

Besides, I realized that consciousness means personal responsibility in action. People in our countries cannot carry Naloxone safely as they may have problems with police. Considering this, talented Sergey Bessonov and Dima Shvets came up with a way of how to make boxes and Naloxone packs, which are convenient to keep in a glove compartment in a car or at home. There is even an “excise label” to store the box until there is an emergency. They make those boxes for people, with love and understanding. They are stylish, nicely sized and pleasant to hold. Such boxes are made in the social dormitory of Ranar Charitable Foundation in Kyrgyzstan.

The yellow box, which came to me from Scotland, has already renewed its stock of Naloxone and now has other helpful things as well. The last thing I got from a friend of mine were tablets, which help in case of MDMA overdose.  In the center, there is a syringe with Naloxone. 

If someone needs help, I am ready.

“90% of successful reanimations are the ones when someone did something,” says the emergency care doctor.

 August 30-31, 2019

EHRA is seeking a consultant to provide support in the development and operationalization of an organizational Monitoring, Evaluation, & Learning (MEL) framework

Eurasian Harm Reduction Association (EHRA) is currently in the process of developing its new 5-years strategy 2020-2024 which will highlight a renewed set of ambitious strategic goals. The new strategy requires new approach to Monitoring and Evaluation, which should help us to enhance capacity to become more effective and maximize our impact. 

Purpose of the CONSULTANT’S work

To provide support in the development and operationalization of an organizational Monitoring, Evaluation, & Learning (MEL) framework.

Objectives

  • To propose the overall organizational approach to monitoring, evaluation and learning taking into consideration existing operational systems and procedures in organization.
  • To propose key impact, and outcome indicators for new EHRA strategy 2020-2024 objectives
  • To suggest system of collecting, analysis and using data based on existing M&E practice used in EHRA, international best practices and donor requirements.

Develop user guideline for EHRA staff which will include efficient methods and tools for data collection and analysis of indicator information; practical management of MEL related processes, including clear schedules, responsibilities and interconnections.

Deliverables

  1. EHRA MEL framework.
  2. EHRA MEL framework implementation guideline
  3. Tracking tools, data management and reporting systems

Timeline

We estimate that this work takes maximum 12 days over two months, to have enough time for reviewing and commenting on drafts. 

Experience and skills requirements

To assess submitted applications, the following criteria will be used (the maximum possible amount of points is 100):

  • Up to date knowledge of Monitoring, Evaluation and Learning best practices, concepts, donors’ requirements and tools (25 points).
  • Proven track record of experience in developing monitoring, evaluation and learning frameworks (25 points).
  • Excellent written communication skills (10 points).
  • Oral, written and spoken fluency in English, Russian is an asset (10 points).
  • Understanding of harm reduction, drug policy, HIV response and/or civil society involvement into advocacy and capacity building in social and public health issues (10 points).
  • Reasonable cost of services (20 points).

How to apply

To respond this announcement, please read Terms of Reference carefully, submit your CV, Letter of Interest and filled daily rate form (see here: EHRA’s template) by e-mail referenced under title “Consultant for MEL” to irena@harmreductioneurasia.org by 24:00 EET, 27 of September 2019.

Letter of Interest should clearly reflect the competencies of the candidate required to complete this task and include:

  • A sample of previous work, relevant to this consultancy.
  • An operation plan proposing how the work will be done and how the objectives above will be met (max 4 pages). This will be subject to review and negotiation.
  • Details/expertise of your institutional affiliation if applicable.
  • An all-inclusive financial proposal for the work, including daily rate in this template (in euro or US dollars).
  • Details of two references.

ToR for a Consultant.

Let’s act together! Join EHRA to clarify an official position of the Ministry of Health regarding the harm reduction in Lithuania!

To everyone. Urgently.

NGO “Young Wave” (Lithuania) participated in the call for proposals for prevention projects, social information campaigns, scientific research projects, announced by the State Public Health Strengthening Fund. The application was aimed at raising awareness of the risks of the psychoactive substance use and harm reduction among festival and party goers, thereby encouraging the target group to make responsible decisions regarding the use of the psychoactive substances and health. What is more, application aimed to raise awareness about drug use, harm reduction among festivals and parties organizers and staff, as well to break the stereotypes about drug use in the society.

The application received 0 points, thus NGO “Young Wave” sent the request to justify the tender results and received response from the State Public Health Strengthening Fund under the Ministry of Health, regarding the harm reduction services promotion for non-injecting drug users in Lithuania.

EHRA expresses its deep concern about the position of the State Public Health Strengthening Fund and asks Minister Veryga to state whether this position coincides with the official position of the Ministry of Health.

If you want to hear the truth too – let’s act together!

By August 18, please sign a Joint Statement to the Minister of Health of the Republic of Lithuania. Be sure to include the name of your organization and the country. Eliza Kurcevic (EHRA) will collect your confirmations of your support to E-mail eliza@harmreductioneurasia.org.

Show your support!

EHRA Team

Kestutis Butkus: “The most important thing for me is not the decision of the Lithuanian court or the ECHR, but the fact that my case resulted in the passing of a law on the provision of OST in Lithuanian prisons. This is a real victory. Our common advocacy driving force.”

EHRA presents a series of conversations with people whose names and roles in harm reduction are well known in the region of Central and Eastern Europe and Central Asia, and beyond. They will share with us the most valuable – their experiences, thoughts, memories.

Kestutis Butkus is a well-known activist, one of the first from the community of people, who use drugs in Lithuania. 8 years ago, his right to health was violated by non-provision of opioid substitution treatment (OST) in prison (at that time, Lithuania remained one of the few EU countries where OST was inaccessible to people in prisons). Kestutis chose the path of struggle against the system and not because of, but rather in spite of, became one of the few (alas), who managed to influence the Law. Since 2018, opioid substitution therapy has been introduced in Lithuanian prisons, but we need to remember – this is only the beginning of a long way*

– What were the circumstances of your arrest in 2011?

– Eight years ago, police “apprehended” me by accident – they found a couple of grams of marijuana in the car. I had several outstanding fines at that time and the judge decided to sentence me to forty-five days in detention so that I would fully comprehend my crime. “Let him lie down and think,” she said. At the trial, I mentioned the methadone program, as I had been receiving substitution therapy for ten consecutive years, to which the judge’s reaction was: “This is outside our competence”.

– Wow. Did you agree with that ruling?

– I appealed, but my appeal was prepared by a person without a license (it used to be possible to do it that way) and then I was put on the wanted list. I didn’t know anything about it. Then one day I came to the migration services to collect my passport. First, they locked me in a room, then a convoy arrived and escorted me to prison. First to pre-trial detention, then to Lukiškės (a prison in Vilnius – comment by EHRA). During all that time no one really explained anything to me. I started writing letters – asking “what for”? There was no answer. Then I found out that those were the forty-five days of detention. It turned out nobody actually read my appeal, they didn’t even consider it. The court ruling came into force, which meant I had to be in prison.

On the first day of the detention, a doctor came to examine me, and I asked for methadone. The doctor, whose name was Mendelevich, said: “You’ll find it very hard – we don’t have a program here. I can only transfer you to the prison hospital, but everything is the same there, except that the ward is more spacious, and smoking is forbidden. You still won’t get methadone though, I can only prescribe “cockroaches”.

– What is it?

– We call light psychotropic substances “cockroaches”. They’re prescribed to everyone so that people can withstand imprisonment, but they have nothing to do with substitution therapy. I began to write appeals, requests, but there was no response.

– Do you remember the prison conditions well?

– Lukiškės is an old prison, it was built in the XIX century. At that time, it was considered one of the most modern in the Russian Empire (at that time most of Lithuania was under the Russian rule — comment by EHRA). These days however it falls short of the standards provided at similar institutions in the European Union. The cells are cramped, for four, there is a table, a washbasin and a toilet. Restriction of freedom is in itself a terrible thing, and those conditions make it simply indescribable. The first eight days were awful. I couldn’t sleep, I started suffering from claustrophobia, though I never had it before. I only managed to get through those moments because I could see a piece of the sky and some rooftops through the bars on the window. I was also lucky to have just one other inmate in my cell, not three (my neighbour was also from the community, by the way, but by that time he had gone through withdrawal).

– Did you spend your entire detention in Lukiškės?

– After eight days I was transferred to another prison – Provinishki (80 km from Vilnius – comment by EHRA). Once there I also immediately mentioned that I was on substitution therapy. The doctor’s answer was: “Don’t complain about your addiction. It’s dissoluteness, not illness.” I understood everything… I said: “I don’t need anything. Just prescribe me some aspirin to thin the blood” (I have a heart valve). They gave it to me, along with “cockroaches”. I was left in a one-person cell for fourteen days. All by myself, having bouts of insomnia…

– Did anyone know you were in prison without access to methadone? Were you allowed to have visitors?

– I was allowed to see a lawyer for the first time in Proviniski – my ex-wife contacted Emilis Subata (Dr. Emilis Subata, Director of the Vilnius Center for Addictive Disorders). He in turn contacted the “I Can Live” Coalition (Vilnius, Lithuania), as I was their member. They managed to hire legal protection for me. Then we thought that this incident could set the wheels in motion for the introduction of OST in Lithuanian prisons. At that time, civil society had been trying unsuccessfully for more than ten years to discuss the matter with the prison department of the Ministry of Justice.

– What measures did the solicitor take?

– He prepared a petition to the prison authorities demanding that they provide me with methadone and requesting a written reply. As a result, a psychiatrist came to see me … (Interestingly, it was only then that I learned that such a specialist was available in prison). He began to reason with me. I said: “Don’t talk, give me a letter.” It was exactly that that acted as a “catalyst” for the whole process. When I was released forty-five days later, the Coalition’s human rights lawyers read the prison’s reply and confirmed that it could be used to refer the case to court, and that we had a chance to overhaul the system. As for my condition… I couldn’t return to the substitution program for a year after my release. I thought I had dealt with withdrawal and that I was able to pull through but I was wrong. I often left the city to see my friends or went to the forest — I didn’t want my daughter (she was still a teenager then) to see what was happening to her dad.

– When did you manage to become stable?

– It was only after a year that I was able to return to the program. That’s when my “marathon” started. First, we went to the local court – they ruled against me. Then we went to the district court, then to the Appeals court – with the same result. Six years later we reached the Supreme Court.

What was the ruling?

– Same as before. That’s why we wrote to Strasbourg, to the European Court of Human Rights (ECHR). The court looked into our case, registered it with a number and accepted it for consideration. The ECHR works according to the following procedure: there are two Chambers. The first one determines whether all opportunities have been exhausted at the national level (in our case it was a yes). And if so, transfers the case to the second Chamber. As soon as that happened, the Lithuanian State literally “woke up” – representatives of the Ministry of Justice, the management of the two prisons I had been in, and the Ministry of Health. Six years on, the Ministry of Health suddenly “remembered” that they had a damage recovery commission, which was to be contacted no later than two weeks after an incident. Of course, I had not contacted the commission. I filed an appeal to the Supreme Court of Lithuania for a retrial based on that fact. It stalled the whole process.

– What was the reaction in Strasburg?

– The ECHR wrote to my lawyers asking what was going on. Lawyers reported that the Ministry of Health had taken the case to court. Upon learning that Strasbourg suspended the case pending clarification.

– Circles of Hell all round…

– Another year went by. In 2018, the Supreme Court acknowledged that I was the injured party. The damage caused to me was estimated… at three hundred euros, plus a bit more for the lawyers and redress – the court admitted I had been right. We appealed those three hundred euros – the court added another thousand on top and just over a thousand for my defence. However, after talking to my lawyers, I decided not to stop there and filed an appeal to Strasbourg over other violations – conditions of detention, standards of hygiene and size of the cell. In the West, such conditions constitute torture.

Last summer, Strasbourg accepted my case. Based on international case law, the lawyers requested thirty-five thousand euros in compensation. And I want to add – that is not a huge amount. There were similar cases in Poland and the UK, where the compensation was about a hundred thousand or more.

– If ECHR rules in your favour, who’s going to be liable for compensation?

– The state. To be more precise – the Justice Ministry. The most important thing for me however is not the decision of the Lithuanian court or the ECHR, but the fact that my case resulted in the passing of a law on the provision of OST in Lithuanian prisons. This is a real victory. Our common advocacy driving force.

– That is, from now on, if someone in need of methadone is put in jail, they’re going to get it there?

– In prison, remand prison, temporary detention facility – everywhere. The law applies to anyone detained for two or more days. There is a catch though. Only those who are officially enrolled on the OST program can receive methadone. We won’t leave it as it is though – the community is putting pressure on the prison department writing letters asking to amend the law and I hope we will be heard.

– Why do you think it took the prison department years to resolve the issue of access to life-saving treatment in prisons? Ruining hundreds of lives along the way – of those who didn’t dare to stand up to the system. Was it money?

– The prison department have a healthcare department within it. And the healthcare department thought that introducing OST in prisons was a very complicated and costly process. They argued that they needed millions to do it. I remember another argument of theirs – where would they keep methadone in prison, it requires special storage conditions! Where else if not in prison! What could be easier than designating a room and installing a methadone dispenser! Implementing the program did not require any significant funds. Who knows though, maybe the prison department just wanted to get some extra money from the Justice Ministry? They are like a state within a state, aren’t they – they report to it but at the same time are independent. They even have their own special internal system, ranks and epaulets.

– It’s like an iceberg then – you can see the reasons that are at the top, that’s 10 per cent, but there are more issues underwater which account for the remaining 90 per cent of barriers.

– I’ll give you another example. They opened the so-called rehabilitation centre for drug users at a prison in Alytus (town in Lithuania – comment by EHRA.) They constructed a building for it especially, furnished it with everything new. Guess who’s moved in there? The entire bunch of the prison’s top dogs, inmates who have nothing to do with the rehabilitation program. Furthermore, they were selling drugs from there for a few years. You think the prison authorities didn’t know that? After all, it’s no secret that drugs are available in prisons at crazy prices. How could such amounts of drugs filter their way into institutions without some help on the inside, from the staff? –

The introduction of the methadone program has slashed the numbers of paying “clientele”. Therefore, my answer about the reason for such a disastrous delay in the implementation of OST in prisons sounds simple – “not profitable.” And I’m happy that my case managed to break the deadlock.

* – According to the Report by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) from 2018: “…at Alytus, Marijampolė and Pravieniškės Prisons… Opioid substitution treatment was still not available in prisons visited. As in the past, methadone maintenance treatment was continued for persons in police custody but discontinued after their transfer to a prison. Further, there was still nothing on offer in terms of harm reduction, such as a syringe and needle exchange, distribution of condoms, etc.” https://rm.coe.int/168095212f

 

The future is intersectional

Author: Maria Plotko, Program Officer, EHRA

Over the last few months, two important conferences on drug policy and harm reduction took place in Europe: activists were sharing best practices and tools at the International Harm Reduction Conference in Porto, whereas researchers were presenting their findings at the  annual conference of the International Society for the Study of Drug Policy in Paris. The two conferences shared the topic but crucially did not form joint advocacy efforts. What drug policy movement needs now is to connect these two worlds. Here are my highlights from both conferences.

  • Porto

The past Harm Reduction conference like probably always was the place where every person is not just tolerated but welcomed with a warm hug. Coming from Russia, where harm reduction is not really a mainstream,  it felt like a huge opposition gathering. The topics I followed were drug policy, human rights and providing funding for harm reduction. 

In accordance with the slogan of the conference — “people before politics” — quite a lot was said about human rights. We, as a society, tend to blame individuals and trust the system to fix them, but it is in fact more fair to blame the system and the state, and give individuals the tools and autonomy to change it. Changing the existing drug policies is a political process, as well as citizen discussion, so  we need to use the existing mechanisms to push the governments further. For example, professor Rodrigo Uprimny who is also one of the members of the UN Committee on Economic, Social and Cultural rights spoke about the “Berlin wall” between Geneva as the home of human rights and Vienna as the host of the Commission on Narcotic Drugs. “We should build the bridge and make drug policy a human rights issue,” he said. The first step was done by the Chief Executives Board of the 31 UN agencies which, right before CND, adopted a common position on drug policy that endorsed decriminalisation of possession and use of drugs.

As Nanna Gotfredsen from the Danish Street Lawyers said in her talk, by documenting the harm caused by repressive drug policies we can easily show what putting politics before people means. If only we could do the same with stigma and discrimination that these policies entail. People who use drugs are criminalized, stalked by the police, and at the same time have a hard time accessing legal aid almost everywhere in the world. There was a special session at the conference aimed at discussing the practices of paralawyers, or street lawyers, as a solution to this issue. Such programs of peer help to victims of human rights violations or violence  have been implemented in Denmark, Indonesia, and Russia, among others, and they were proven to be effective even in such severe circumstances as in the case of the Philippines.

For people coming from countries with draconian drug policies, like myself, the Portugese officials said a lot of groundbreaking things like ”criminal justice is never good for issues related to drug use” coming from the police representative or everyones favorite from a member of parliament Ricardo Baptista-Leite ”harm reduction and love have one thing in common they both should be unconditional”. To get to the world with a human-rights-based drug policy, we should encourage politicians to meet with people who use drugs, and, more generally, make people living at the margins of the community visible to the community and be helpful not only to people who use drugs but also to politicians and the police, ”allow them to take credit and praise them.”

  • Paris

A month later, another drug policy conference took place in Paris, this time bringing together scholars from all over the world. It was the 13th annual conference of the International Society for the Study of Drug Policy. For EHRA, this was the first time attending such a gathering.  Most of the speakers there were from the UK and the United States, some were representing Africa and Latin America. Our CEECA region was severely underrepresented at the conference, as I remember only two presentations covering Poland and the Baltic states (one of which was mine),  an done talk concerning a comparative analysis of drug policies in Germany and Azerbaijan.

Due to the growing number of countries which have legalized cannabis for medical and/or recreational use, the number of presentations on various issues related to this vast topic was enough to spend three whole days listening only about it. At the opening of this conference Anne Souyris, the Deputy Mayor of Paris for Health, said: ”We always wait for dramatic health events to implement harm reduction. In order to be effective, drug policy should be flexible and adaptable. We should do it on the go, start small and then structure if necessary.” But even if the government is pro-active, the role of civil society is to keep the topic on the agenda, to work with the government, and make the law better. In Uruguay, before the legalization of cannabis, over 60% of people were against it at the beginning. The president administration initiated the reforms in order to fight against drug trafficking, not necessarily for the benefit of the people or in the name of human rights, and the adopted legislation would have never been as we see it today if it wasn’t for the activists.

All the relevant arguments that we as advocates and harm reduction practitioners need were represented there: the efficiency of drug consumption rooms, the importance of decriminalization and depenalization, legalization of cannabis, and sensible policing. There was an interesting presentation which concerned an analysis of all publications on decriminalization which revealed that prevalence of use is taken to be the dominant indicator of drug policy success. As a result, it seems that countries pass the laws for one reason, and then evaluate a totally different thing.

Due to “insufficient methodological tools to conduct community-based research,” community involvement in the research was presented as a new trend. The reasons why researchers ‘should’ collaborate with peers listed on one of the slides were:

  • Utilitarian: increasingly, funders require it
  • Ethical: peers have the right to be involved in any publicly-funded research that may affect their health status or the services that they receive
  • Epistemological: peers have first-hand knowledge of the issues under consideration
  • Consequentialist: collaboration has the potential to improve the quality, relevance and impact of the research

Whereas HR2019 was filled with people from the community, harm reduction practitioners and advocates, this conference was almost pure science. At the end of each presentation, I was hoping to hear something about how that piece of research was used in policy making, and what was the reaction of the government, health professionals, or any other relevant stakeholders. However, strangely, most of the time presenters did not say a word about the next steps and policy implications that followed from their research, or how it was used in advocacy, or to what extent it was effective. Also, the presenters did not explain the reasons why they had decided to pursue this topic in the first place.

 

To conclude, the two conferences got me into thinking about why although they shared the messages and general conceptual frameworks, they did not share the audience. Stigma related to drugs is divisive even for people who use drugs, one can see the split between “bad drugs” and “good drugs”, for example,  socially acceptable upper-class party use contrasted with “those people in the street we have nothing to do with.” We see separate conferences for harm reduction, psychedelic, cannabis and ayahuasca users, cultivators, scientists and activists, doctors and police, palliative care and access to pain management.  Repressive drug policies affect the quality of life and safety of every person, and can be used as a way of controlling the population and implementing political repressions just the way we recently saw in Russia or like we see it happening every day in the Philippines. We have a common enemy — repressive drug policies. We need to join our forces and create an intersectional drug policy movement.

The future of harm reduction in the CEECA region: EHRA holds a meeting on strategic planning for 2020–2024

The opening of a two-days Strategic planning meeting for 2020–2024 took place in Vilnius today.

On 9-10 July 2019, the members of the EHRA Steering Committee, experts from the Central and Eastern Europe and Central Asia region (CEECA) as well as the key staff of the Secretariat are working together with the aim to analyze the advocacy results of the last two years and plan the future operational activities of the Association.

The strategic objectives for the EHRA’s development were created in 2017 by a team of the Secretariat and the Steering Committee and based on the experience of harm reduction advocacy approaches and analysis of the situation in the region (Strategic framework for 2018-2019). Today, the Steering Committee will analyze the results of the implementation of the Strategy, based on the results of the survey for the Association members.

“It is already clear that we need to “fix”, to restart harm reduction in the region, to choose the most effective approaches to communication and advocacy. I suppose, even through provocations, but to inform the officials about the importance of helping people, not punishing them. I do hope that during the meeting we will be able to come up with new and fresh answers to complex challenges,” – says Anna Dovbakh, Executive Director, EHRA.

The agenda of this meeting is to develop a theory of changes with the answers to the following questions: how do we want to see harm reduction in the CEECA countries in 5 years, and what do we need to achieve this future, considering many factors, such as:

– widespread distribution of new psychoactive substances and the drug scene changes;

– changes in the level of harm reduction funding and the sources of these funds in different countries of the region;

– changes in the quality of harm reduction services and access to services with the transition to the national funding;

– drug policies toughening in countries;

– сhanges in the civil society participation in decision-making processes at the national and local levels.

“For an organization that brings together more than 250 organizational and individual members in 7 CEECA subregions, it is important to develop strategic directions that will consider existing experience and introduce innovative approaches in advocacy; based on the enormous human and intellectual potential, to carry out work aimed at improving the quality of life for one and all at the national as well as at the regional level. It is important to go beyond the standard, not to be afraid to experiment and plan. After all, we are justly fighting for the fate of people, for the quality of their lives and a better future.” – Marina Chokheli, Chair of Steering Committee, EHRA.

“My expectations from the meeting in Vilnius relate to the importance of the role that EHRA plays today in drug policy reform in the EECA region. At the meeting, we need to decide our Strategy and course of the actions, so these changes in the existing punitive laws in most of our countries regarding people who use drugs could occur as soon as possible. The EHRA Strategy today is not a theory and the reasoning, as it could be, but it is our actions on which the life and health of specific people depend. There is a conditional “counter” in front of our eyes that shows how many people TODAY are arrested, how many TODAY have died from overdoses and lack of help, how many TODAY have become HIV-positive, etc.

This meeting is also important for EHRA too. It is important for us to hear each other life, to find common ground in the work of the Secretariat and the Steering Committee, to unite our efforts in order not to become the heroes of the fable “The Swan, the Pike and the Crab.” One team, one goal, actions in one direction – we cannot leave Vilnius without it.”- Alexander Levin, Steering Committee Co-Chair, EHRA.