How are we doing? We’re summing up the first two years of “teal” self-government

Ganna Dovbakh, Executive Director of EHRA

It’s rare when you have a proper reason to tell how everything works inside the organization. You always praise the celebrant on their birthday and that is why today when it’s 2 years from the date of EHRA’s registration, I want to say a few words about us.

The first two years for us were the time of drafting new rules and looking for new approaches – both for our team and for me personally.

What is the added value of the regional network?

This question is usually the first to arise in all discussions, from discussing the development of a new project to information leaflets. Our members are doing national advocacy in their countries, while the regional organization becomes a source of new, unfamiliar, ways to achieve goals, learned from other countries or invented in a heated discussion of the team. We gathered together to invent and look at the world from a different perspective. That is why it is important to involve all members in the discussion. We strive to reach a consensus on the most important issues among 251 organizations and activists during our online meetings. I’m sure it would be perfect…

We come up with our ideas and then we think our common goals through and that is why the participants’ views are changing. For example, in 2018 we collectively developed the position of EHRA on drug policy, and even major experts in harm reduction discovered something new during the discussion. It has become clear to me that drug control is designed to fund law enforcement agencies and prisons. Money is the only indicator of national priorities. Drug policy does not exist separately from advocacy for sustainability of harm reduction services. We collected data to estimate criminalization costs and proved that those millions of dollars could have been spent on social services, which lack so much funding. How is it possible to convince decision-makers to spend these resources on the harm reduction services? We are still searching for the answer.

What do we really have in common? EHRA brings together both organizations of people who use drugs and organizations that provide and develop harm reduction services. We unite very different, sometimes even warring states: the EU members, the countries that want to join the EU and the countries of the Eurasian Customs Union. Despite visible differences, politicians regard the needs of people who use drugs in a similar way in all these different counties, and therefore our overall objectives remain the same.

The elections to the Steering Committee of EHRA were held in different sub-regions and within a community of people who use drugs in 2018. Our new SC is very diverse but their members are united in their vision of priorities, which can be observed in decisions they make – from the choice of strategic partners to the selection of project performers.

My heart filled with great pride when a member of the Steering Committee justified the decision of the Association on partnership to one of our international partners. It was clear that this decision was balanced, wise and unanimous. There wasn’t even a single thought that the Secretariat could compromise. That’s exactly why we have the Steering Committee, its main purpose is to make decisions. Democracy is a painstaking and time-consuming process. Activism requires resources and, most significantly, it requires time.  And here I would like to thank EHRA members and especially our SC for the efforts they made and the time they spent on the development of our organization.

How do you make a horizontal management structure effective?

The Secretariat is an executive structure, it consists of project managers. I think it’s foolish to gather a team of great experts while being unable to give them the opportunity to come up with ideas and make decisions. It’s impossible to know, understand and feel everything that 13 people understand, feel and know.

The management systems where each employee can invent something and influence decisions have different names. They were once called partnership management structures, horizontal structure, or “empowering” management. All these approaches have been recently united into the concept of “turquoise/teal teams”. I can’t say that our Secretariat is already turquoise but we’re learning.

Frédéric Laloux describes such organizations of the future as living organisms. They are notable for self-organization, integrity and evolutionary goals. Staff of such organizations perceive their companies as a living creature with a soul rather than a lifeless mechanism or machine, they think that their organizations are able to develop themselves without managerial control or fixed strategic annual plans. Teal companies have moved from “pyramid structure” to “teals”: from rigid hierarchical structures with supervisory control to distributed leadership and project teams. Employees are perceived as individuals rather than tools. One of the “teal” indicators which is so important for me is that it’s comfortable to work here for people who use various substances, people with children or pets. You definitely could recognize “therapy dogs” in our office from our posts on social networks.

The experience of these two years of our “dream team” shows that we are the most effective in actions which are developed and experienced by people. Only when staff believe in action with all their hearts, success could come.

Access to information for all is the most important thing to ensure if you want to implement the principle of involving every team member in daily management. Our mailing list makes it possible to discuss events and plans and is very helpful for me. Anyone from the team can write there to alarm others of problem we have and almost immediately get various solutions to it.  All Secretariat team members discuss and develop goals, not just the management. With knowledge of accessible information about the region and the situation in the countries and rooting for the common cause, people come up with the simplest and most effective solutions. Thus, the movement of drug feminists, our assessments and new projects were born. When each employee and member is provided with opportunities to create and implement their crazy ideas, then we are able to act “out of the box”. The next challenge is to try and fit it into the overall organizational strategy and inspire the donors with these ideas.  If we believe in it, we could prove and justify, then we will be able to involve even the most bureaucratic donors with the most abstract priorities.

How do you become an effective Executive Director of the “teal” team?

When we gather together a team of high-level professionals who are always in the information flow and maintain constant contact with countries, it’s absolutely possible for them to make key decisions in their areas. The role of the executive director is to align all the activities with the overall strategy and use the wisdom of compromise.

I once found a short description of the leader’s tasks: identify the environment for your team (the context in which we operate, the players and all the challenges we might face on our way), set goals and then tirelessly thank people for their ideas and day-to-day work. My task is to inspire the team to reach ambitious goals and connect all the different ideas and people. I also should be an expert on experts, gather partners and like-minded people.

Someone asked me if it is possible for an anarchist to become a director. It seems possible to me, if we are aware that we are all equal in the team and recognize the importance of each other.

There are a few simple rules that help me avoid mistakes every day. They might be useful for you:

– Answer emails and read documents. Reading key documents, calls for proposals and position papers should be included in your work plan, the same as you do with meetings. An outside perspective for our documents make the message clearer and help us get rid of excessive emotions and too much passion.

– Don’t make quick decisions, give yourself time. Sometimes in order to make a decision you have to walk a few kilometers or get a night of quiet sleep. If you don’t have enough information to make a decision, specify it and consult others.

– Every director should be responsible for supervision and staff development.  Avoid petulance and hasty judgements, as hard feelings wrench a creative spirit. And trust is inspiring.

We are only setting off on our interesting journey. We are strong when we are together!

The direct speech of Oksana Ibragimova at the 65 session of the CESCR

The direct speech of Oksana Ibragimova, Kazakhstan Union of People Living with HIV and the member of EHRA’s Steering Committee at the 65 session of the UN Committee on Economic, Social and Cultural Rights (*CESCR) meeting:

My name is Oksana Ibragimova, I represent the Kazakhstan Union of People Living with HIV. We work with the Eurasian Harm Reduction Association and the Canadian HIV / AIDS Legal Network. In my four-minute speech, I want to focus the attention of the Committee on the main problem that hinders the prevention of HIV infection among people who use drugs, including opioid substitution therapy.

I am talking about criminalization of drug use, including the criminalization of drug possession for personal use. Due to criminalization, the main focus of drug policy in Kazakhatsan is on law enforcement, and not on health care.

It is precisely because of the resistance of the law enforcement agencies that the substitution treatment program in Kazakhstan is threatened with closure. The repression of law enforcement against people who use drugs is responsible for the increased vulnerability of people who use drugs to HIV. More than 50% of new HIV cases occur due to the use of non-sterile equipment for injecting drug use.

In its responses to the Committee’s List of Questions, Kazakhstan indicated that it is the Ministry of the Interior that is responsible for drug prevention. “Preventive registry of drug users” is indicated in the responses as preventive measures. This is a measure by which people who seek medical care are denied in their rights. This registry is not only not conducive to drug prevention. It impedes the realization of the right to health. This is just one of the examples showing that the police structure is not able to engage in adequate prevention among young people and among the most vulnerable and socially marginalized groups of the population. An excessive focus on law enforcement and repressive drug control measures hinders HIV prevention and other health measures among people who use drugs.

Drug policy issues need to be passed from the hands of law enforcement to the hands of public health, public education, and social support systems for the most marginalized groups.

In this regard, in addition to the recommendations on substitution treatment, we ask the Committee to recommend to the Republic of Kazakhstan to change the repressive focus of drug policies in regard to people who use drugs and, in particular, to decriminalize drug possession without sales goal.

 

* – Established in 1985, CESCR is a UN human rights body consisting of 18 independent experts that monitor implementation of the International Covenant on Economic, Social and Cultural Rights by its States parties, which are obliged to submit regular reports to the Committee on how the rights are being implemented in their countries. The Committee’s rules allow for international, regional, and national organizations and human rights institutions to submit parallel reports with questions for governments in advance of the dialogue with the states.

Extended. EHRA is looking for an Analytic Consultant

In the framework of project “New Psychoactive Substance Use in Moldova and Belarus” EHRA is seeking to engage qualified professionals from Belarus and Moldova, one consultant per country, for conducting document analysis for assessment of the use of the new psychoactive substances (hereinafter – NPS) in Belarus and Moldova.

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“There are normal people, and there is me, and there is a difference”: voices of the women, who use drugs from Estonia at the 65 session of the CESCR*

In 2017 EHRA together with Canadian HIV/AIDS Legal Network and LUNEST submitted shadow report and presented it at the 62  Pre-sessional working group of the UN Committee on Economic, Social and Cultural Rights (CESCR*) meeting in April, 2018. The report was made based on the study conducted in Estonia in 2017.

In the result the following question was included to the list of issues and on February 18-20, 2019 representatives from EHRA, LUNEST and the Human Rights Clinic from Miami University School of Law joined the 65 session of the CESCR to speak about the human rights violations faced by women who use drugs in Estonia.

We share a direct speech from the Committee meeting – a Statement by NN**, a woman, who uses drugs from Estonia.

Hello, my name is [NN]. I represent LUNEST. I live in Estonia. I have been using drugs since I was 12. Today I have two children.

I want to tell you that people who use drugs are exposed to severe stigma from medical staff. Not only in general hospitals, but also in places which work specifically with people who use drugs. Once I was told by an opioid substitution treatment center staff that there are normal people, and there is me, and there is a difference. That OST is useless, that I will take methadone until my old age, and if I leave, I will for sure come back, as it has happened to many others, as this is not a treatment at all. Many OST workers think that they are distributing drugs. Such rhetoric and behavior are not permissible. It shows a complete lack of awareness of harm reduction among healthcare workers. Such behavior keeps a person away from resocialization, and her self-confidence falls. This can lead to relapse. The rhetoric of hate kills people.

In addition, attitude to personal data is extremely negligent. When I was 13, the police came to our school. They searched children, and some were taken away for drug testing. I was among them. Results of the drug testing should have been known only to parents, but eventually the entire school, every teacher, knew the results. No one has helped me. I was transferred to home education, I was isolated from others. Today the disclosure of personal data leads to the fact that the results of tests that are taken during substitution treatment, are known by social services that can take children away, and blackmail mothers. In addition, staff of substitution treatment centers can call the employer and tell where they call from. People living in the region with the highest unemployment rate in Estonia are losing their jobs. For example, a woman with a small baby recently lost her job that she liked a lot.

Every woman who uses drugs has experienced violence. In my case, I cause small scale health damage to a man while trying to protect myself. I defended myself from a strong man. The police was not interested in my case, and I had to go to hospital on my own and pay for medical examination to certify my injury. I was a woman who used drugs, and the “victim” was a man, obviously stronger than me? No! He was my husband. The police said that I should not fight for our child, because I am an unemployed drug addict, without my own apartment. By that time, I was fired after the employer had learnt that I had used drugs a long time ago. I was told that our daughter would stay with my husband anyway, if he wanted, and I would only get things worse.

In 2012, I was caught by police for drug checking right in the street when I was walking around the city. I haven’t been using drugs by then for five years, and drug test showed methadone along. But a police officer loudly said in the corridor full of people: “I am so tired of you, addicts”. I haven’t used drugs for many years, so I cried.

I have known about the punitive juvenile system since I was 13, and I have never seen anything except deception. No help even when I asked for it. We have no centers where a woman could undergo rehabilitation without leaving the children, but to leave a child in that system even for a while often means to lose a child forever. For example, there was a condition for a woman to leave the methadone program in order to restore custody over her child. Women who use drugs love their children, but I saw how they gave up. When they face violence, they have no place to ask for help, and I have nowhere to go too. No one gives information.

Today I am not even trying to defend my right to see my daughter because she was taken by my ex-husband. Because I know that this can lead to restriction or loss of my parental rights.

Women are afraid to ask for help, I’m not the only one.

Thank you for your attention, I will be happy to answer your questions.

 

* – Established in 1985, CESCR is a UN human rights body consisting of 18 independent experts that monitor implementation of the International Covenant on Economic, Social and Cultural Rights by its States parties, which are obliged to submit regular reports to the Committee on how the rights are being implemented in their countries. The Committee’s rules allow for international, regional, and national organizations and human rights institutions to submit parallel reports with questions for governments in advance of the dialogue with the states.

** – NN asked not to disclose her name because of the fear of prosecution and further discrimination in healthcare and social services settings. NN is also concerned that OST program staff’s attitude to her may be worsened in case of her name disclosure.

 

p.s. We are pleased to report that the session ended in a high note: two Committee members pressed the Estonian delegation on all the issues we had presented, including the separation of children, Estonia’s harsh drug policy, the lack of OST and ART access, and the needed to end de facto criminalization of drugs, among other issues.

Developing the capacity of CCM members representing civil society in Central Asia: a two-day workshop took place in Almaty, Kazakstan

On February 13-14, 2019 in Almaty, Kazakhstan, the Eurasian Harm Reduction Association (EHRA), within the framework of the Regional Communication and Coordination Platform project in the EECA region, with the support of the Global Fund, held a two-day workshop on “Developing the capacity of CCM members representatives civil society in Central Asia” for CCM representatives from the non-governmental sector from 4 countries of Central Asia – Kazakhstan, Kyrgyzstan, Tajikistan and Uzbekistan.

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EHRA and the Alliance for Public Health call to join the Valentine’s Day Global Action in support of the Global Fund’s efforts to ensure the necessary level of investment within the Sixth Replenishment

On the 11th January 2019, the Global Fund announced its fundraising target for the next three-year cycle for 2020 – 2022. The Executive Summary of the Sixth Replenishment Investment Case describes how a minimum of US$14 billion will help save 16 million lives, cut the mortality rate from HIV, TB and malaria in half, and build stronger health systems by 2023. The Global Fund’s Sixth Replenishment Conference will take place in Lyon (France) on 10 October 2019.

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Robert Carr Network Fund announcing the Funding Decision for the period 2019-2021

We are happy to announce that RCNF acknowledged the achievements of the Eurasian Regional Consortium in the HIV response in the EECA region and provided USD 1,760,000 to continue the Consortium advocacy and capacity building activities in respond to funding insecurity for HIV services for key populations in EECA for the next three years.

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Lithuania rings a bell – “Reform of the Psychoactive Substances: Support, don’t Punish” Conference has started in Vilnius

The aim of the Conference is to show the overall drug policy situation in the international context and how it affects people, who use drugs; to provide to the audience the historical context that led Czech Republic and Norway to the decision of decriminalizing drug use and possession for use; to teach and share with Lithuanian legislators best practices of the drug policy reforms, by giving more international expertise.

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Time to Act! The 4th European Harm Reduction Conference

November 21, 2018

11.45 – 12.30

Panel discussion: Harm Reduction future: sustainability and impact

Moderator: Ganna Dovbakh and Wolfgang Phillipp

Naomi Burke-Shyne, HRI

Katya Lukicheva, OSI

Palani Narayanan, Global Fund

Susanna Ronconi, Forum Droghe, Italy

Marian Ursan, Carusel, Romania

12.30 – 12.45

“Chase the Virus, not People!”

Ganna Dovbakh, EHRA

16.00 – 17.30

Parallel session 7*: Bringing treatment to the community (HA REACT) 

Chair: Alexandra Gurinova

Co-organised by the European Joint Action on HIV and Co-infection Prevention and Harm Reduction (HA-REACT), HA-REACT addresses existing gaps in the prevention of HIV and other co-infections, especially tuberculosis and viral hepatitis, among people who inject drugs (PWID). It is a joint effort of 23 organisations in 18 EU Member States, and focuses on those countries where there are obvious gaps in effective and evidence-informed harm reduction interventions, or where such interventions are not being implemented at a sufficient level.

Gender approach in testing and other harm reduction interventions

• Alexandra Gurinova, Deutsche Aids Hilfe, Germany

• Olga Belyayeva, Eurasian Harem Reduction Association, Lithuania

Integrated care for people who use drugs – challenges and recommendations

• Kristel Kivimets, National Institute for Health Development, Estonia

Responding to HIV and overdose epidemics in Estonia

• Aljona Kurbatova, National Institute for Health Development, Estonia

Drug policy change through the lens of OST treatment implementation in Lithuania

• Morgana Daniele, Youth Rise, UK

November 22, 2018

11.00 – 12.30

Parallel session 12*: Transition and sustainable funding of harm reduction (OSF), part 1

Room: 2 – MIRCEA ELIADE
Chair: Ekaterina Lukicheva

This session aims to increase the understanding of progress and key success factors that lead to sustainability of HR programs in countries transitioning from Global Fund’s support of HIV response to national funding including the role civil society and community representatives plays in these processes.

Participants will:

  • Learn about the harm reduction financing changes and donor transition related processes taking place in SEE countries
  • Better understand key facilitators and factors that lead to their programmatic and financial sustainability
  • Learn from the experience of civil society and community representatives advocating for sustainability of HIV prevention services among key affected populations in their countries.

14.00 – 15.30

Parallel session 17*: How to leverage EU membership and accession for increasing sustainability and quality of harm reduction services at country level (OSI part 2).

Room 2 – MIRCEA ELIADE
Chair: Raminta Stuikyte

This sesison will discuss the challenges, lessons learnt and possible opportunities for NGOs in those EU member counties which lack of the political will to ensure the sustainability of harm reduction services at the expense of the state budget
Participants will:

  • Learn more about the political, technical, funding opportunities and instruments available for NGO in EU member and accession countries which could help to improve the sustainability of HR services they provide
  • Get an opportunity to discuss their situations, share their concerns and learn from each other’s experiences of advocating for the increase of the governmental funding for HR services

November 23, 2018

09.00 – 10.30

Parallel Session 26: Drug policy trends: alternative to coercive sanctions

Room: 1 – Aula
Chair: Ganna Dovbakh

This session aims to provide space for discussion on current drug policy trends in Europe, the impact of international drug policies on European national policies and practice and the ways of transferring European best practices to other regions.

Participants will:

  • Increase their understanding of the perspective of young people on the international and national drug policies;
  • Learn about the current state of advocacy for decriminalization, legalization and alternatives to coercive sanctions (ACS) in Europe;
  • Learn about pilot diversion from arrest programs in EU and barriers to their integration;
  • Share perspectives of EU best practices in drug policy that could be promoted outside of the EU.

Shrinking space for harm reduction and human rights in EU based on Hungarian situation

Peter Sarosi, Drugreporter, Hungary

Promotion of Alternatives to Coercive Sanctions (ACS) Programs in EECA

Dasha Matyushina, Eurasian Harm Reduction Association, Russia

Guidelines for law enforcement to improve public health outcomes for YPUD

Morgana Daniele, Youth Rise, UK

09.00 – 10.30

Parallel session 29 : Gendered consequences of repressive drug policies

Room: 4 – Simion Mehedinti
Chair: Eliza Kurcevič

The session aims to provide space for women who use drugs and specialists working with this group to share and discuss gender specific consequences of repressive drug policies and the availability and quality of existing services inclusion of the community in the global women’s movement.

Participants will:

  • Learn about recent studies of human rights violations of women who use drugs and the process of submitting complaints to UN bodies
  • Increase their knowledge of intersectional feminism and the inclusion of the community of women who use drugs in the global feminist movement
  • Learn about gender differences in substance use and the prevalence of HIV and HCV, and gender-sensitive services including services for women who use drugs who suffered from violence
  • Discuss how to protect and minimize risks among activists and human rights defenders

Gender differences among people who inject drugs (PWID) in Estonia

Maris Salekesin, National Institute for Health Development, Estonia

Human Rights of Women Who Use Drugs: Institutional Violence and Human Rights Abuse by OST Clinics’ Staff

Maria Plotko, Eurasian Harm Reduction Association, Lithuania

Harm Reduction Challenge: public nuisance vs public health

Aura Ruig, Metzineres, Spain

Protection of Harm Reduction and Community Activists from Pressure, Arbitrary Arrest and other Forms of Abuse by Authorities

Dasha Matyushina, Eurasian Harm Reduction Association, Russia

Harm reduction from perspective of feminism and history of the feminist movement

Fenya Fischler, Association for Women’s Rights in Development, UK

 

* – The list of the sessions, in which the representatives of EHRA’s team took part in their preparation