Human rights violations of PWUD related with barriers to access treatment and other health services during Covid-19 in North Macedonia

Interview with Milka Spirovska, NGO “HOPS”, North Macedonia.

In 2021 “HOPS” implemented a small grant within “We Will Not End AIDS Without Harm Reduction” project framework.

Which human rights violations of people who use drugs you observed during Covid-19 times?

People who use drugs continuously face numerous violations of rights and discrimination. During the pandemic caused by Covid-19, in addition to the violation of their rights in the field of health care, people who use drugs also faced violation of their social rights, labor rights, family rights, protection from domestic violence, etc.

Regarding the violation of social protection rights, people who use drugs faced various problems: lack of information about the changes in rules, procedures that often occurred as a result of frequent changes in the epidemiological situation, inaccessibility to representatives from the competent institutions, slow decision making on their cases (people who use drugs have been waiting for months for institutions to respond to their requests for exercising the right to guaranteed minimum assistance, financial compensation for assistance and care from another person, education allowance etc.) The most serious identified problem is the rejection of their claims for social protection rights that they have been using for years.

They also faced violation of worker’s rights. People who use drugs, who have been employed face the loss of their jobs or the non – renewal of their expired contracts, and in particular the inability to earn for a living or those who were part of the informal economy.

Regarding the violation of family rights, they faced the deprivation of their minor children by the Centers for Social Work due to the fact that they are being treated for addiction with substitution therapy.

There were also cases of domestic violence in which the rights of people who use drugs were not protected by the competent institutions. The competent institutions did not act upon the reports with the explanation that there are private family matters, or initiate proceedings against them due to disturbance of public order and peace.

How you supported people whose rights were violated within this project (small grant)?

For more than 20 years, HOPS has been committed to promoting, respecting and protecting human rights and freedoms in order to improve the health and socio – economic status of marginalized communities, especially people who use drugs and sex workers, through equal access to services, community building, capacity building, research, analysis and advocacy. In its activities, it primarily implements its activities in order to improve the status of people who use drugs and sex workers, as well as all other marginalized groups in society.

This project has enabled us to help people who use drugs, including women who use drugs, to have better access to treatment and other health services by providing free legal aid. Through the reported case, the legal advisors identified cases of violations of rights in the field of health care and motivated the clients to report the cases to the competent institutions and bodies.

Two clients were motivated to report their cases. In both cases, the legal advisor for the clients prepared complaints to the Ombudsman. In other cases, clients were not sufficiently motivated to report their cases due to distrust of the system and institutions.

Through the online thematic discussion in which people from state institutions took part and the three videos that we made within this project, which contained personal stories of violations of rights in the field of health care of our clients, we saw the problems that are facing people who use drugs, and which problems were highlighted during the Covid-19 pandemic.

In some countries, Covid-19 created loads of challenges not only for people who use drugs, but also for the civil society organizations/ service providers. Could you please tell us, what new challenges did you face because of Covid-19?

The Covid-19 pandemic was a challenge for both our clients and our organization. Adhering to the measures and recommendations of the Government and the Protocol for organizing the work of HOPS in an emergency caused by Covid-19, HOPS reorganized the work in a way that the employees had been working from home. The exception was the field workers who performed field activities. Тhey were constantly at the front and provided our clients with the necessary equipment, but they were protected with appropriate equipment (protective gloves and masks, disinfectants), in order to protect their health and the health of our clients. The clients were contacted by phone and were continuously informed about the measures, recommendations and conclusions of the Government, and in emergencies where they needed help from our employees, they received the appropriate services.

One of your activities was a launch of awareness raising campaign for improving health rights of PWUD by promoting the 3 short videos with people stories. How the public and stakeholders reacted to this campaign?

We faced a challenge in motivating clients to tell their stories. It is very difficult to motivate clients who have faced violations of rights to speak publicly about their problems and it is even more difficult to report cases to the competent institutions, due to, as I mentioned above, their distrust of the system and institutions. However, videos were promoted on the HOPS website, social media Facebook and Instagram and YouTube and we had the uploaded videos viewed. We believe that we have reached the public and we have successfully reached the goal of the planned activity.