'Accept me': Near Ukraine front, a haven for outcasts

Whenever warm days come to Kramatorsk, near the eastern Ukrainian front, the Svitanok organisation leaves its door wide open, offering advice or a cup of tea to the city's social outcasts.
People living with HIV, those recovering from drug addiction, sex workers -- all are welcome to seek medical guidance and respite from stigma and solace as Russian troops advance toward Kramatorsk.
The refuge they find at Svitanok is vital during the war, when marginalised communities often feel left behind and face heightened insecurity and stigma.
"They support me here, they respect me. I just came to drink some tea. They'll treat me, I know they'll accept me," says Oleg Makaria, who is HIV-positive.
Makaria, who comes to Svitanok most days, hardly reacts to the air raid sirens once again wailing in Kramatorsk, just 20 kilometres (12 miles) from the front.
The 41-year-old jokes that he does not look his age. But he suddenly breaks down thinking about Donetsk, his home city now in Russian hands.
"I understand I can't return to Donetsk anymore. Never in my life. Probably... I'm here alone," he mutters through tears.
Moscow-backed separatists seized parts of the Donetsk region in 2014, a prelude to the Kremlin's full-scale 2022 invasion, which the UNHCR says has displaced nearly 11 million people.
The conflict disrupted treatment -- which needs to be taken daily to control HIV -- to some of the 250,000 Ukrainians estimated by UNAIDS to be living with the infection in 2020.
- 'I didn't break' -
Advances from Russian troops have also threatened drug treatment programmes.
Moscow and its proxies have banned opioid substitution, which replaces dangerous opioids with less harmful substances such as methadone.
Approved by the United Nations and the World Health Organisation, the treatment also reduces HIV transmission as it lowers drug injections.
No one would guess looking at Natalia Zelenina, but the bright social worker sporting a red bob and bright pink lipstick spent five years in Russian custody.
She was carrying legally prescribed drugs for her replacement therapy when she was stopped by Moscow-backed separatists controlling parts of the Donetsk region in 2017.
"I realised how strong I was," the 52-year-old said.
While her colleagues campaigned to get her out, she fought to obtain treatment for her HIV.
"I survived, I endured it all. I went through it all. I didn't break," she said.
After being released to Kyiv-controlled territory in a prisoner exchange, Zelenina returned to Svitanok.
"I knew that I could only recover in a familiar atmosphere," she says.
But even in the protective bubble of Svitanok, where most workers have HIV and a drug dependency, the boom of explosions can be heard in the distance.
One employee told AFP she started consuming "just a little bit" of drugs to alleviate her anxiety –- until her colleagues helped her get clean again.
Iryna Mamalakieva arrives holding her four-year-old son Maksym, who wobbled off at any opportunity to pick dandelions on a patch of grass.
The unemployed 31-year-old former mine operator, diagnosed with HIV in 2019, relies on Svitanok for medical and legal help.
"Some people give up, some hang themselves. I knew people like that: They found out about their diagnosis, and even if they had children, they drank themselves to death and quietly went to hang themselves," she said.
- 'Melancholy in my soul' -
The war has exacerbated stigma towards HIV-positive people and those suffering from drug addictions, counsellor Svitlana Andreieva told AFP.
"The rest of the world that's outside our doors, it tells them that they are nobody, that they're not accepted, they're not respected," she said.
Andreieva herself remembers being kicked out of hospitals and beaten up by the police because she was addicted to drugs and HIV-positive.
Then she learned law, which she shares with visitors who went through similar experiences.
"The next time they don't come with tears," she said. "They say: 'What do I need to do, which law article should I rely on?'"
But Andreieva's patience is often tested.
After an altercation with a regular, she finds a bouquet of lilacs in lieu of apologies in the office.
Hard to win over, she initially shrugs it off.
But Svitanok's workers and beneficiaries face yet another hurdle: cuts in US humanitarian aid.
Svitanok has for now survived Washington's aid freeze, but is scrambling to find alternative sources of funding for some of its many programmes, which partly rely on US money.
The uncertainty "really knocked me out of my stability", Zelenina says.
"There's such a melancholy in my soul, you know? I love my job. I simply can't imagine what I will do tomorrow."
brw/cad/dt/cw/js

Try Our AI Features

Explore what Daily8 AI can do for you:

Learn with AIFact CheckingText to SpeechAI Summary

Related Articles

8 hours ago

In Uganda, a tougher bicycle offers hope for better health coverage in rural areas

LIRA, Uganda -- The bicycle parked in Lucy Abalo's compound doesn't belong to her. Any one of the hundreds of people in her village can show up and ask to use it. A man might wish to take his pregnant wife for a checkup. A woman might need transport to pick up HIV medication. An injured child might need a trip to a hospital. 'The goodness about this bike,' Abalo said, is its availability to all. She is one of dozens of 'village doctors' in rural Uganda who recently were supplied with the Buffalo Bicycle, so called because its steel parts are reinforced to perform in areas with bad roads. World Bicycle Relief, a Chicago-based nonprofit, promotes the Buffalo Bicycle in remote parts of Africa. It collaborates with governments, non-governmental groups and others who use the bikes to improve access to health services. In Uganda, an east African country of 45 million people, efforts to market the bicycle have focused on supporting health workers like Abalo, who visits people's homes and reports any issues to authorities. As a community health extension worker, or CHEW, she has gained the trust of villagers, who can knock on her door in emergency situations. She said she helps to look after about 8,000 people in the area. And at least twice a week, she is required to report to a government-run health center about 5 kilometers (3 miles) away and assist with triaging patients. Ugandan health authorities acknowledge that one challenge for CHEWs is transportation, part of a larger burden of poverty that can leave health facilities lacking ambulances or even gas to move them. World Bicycle Relief, operating locally as Buffalo Bicycles Uganda, has collaborated with Ugandan health authorities since 2023 to equip 331 CHEWs in two of the country's 146 districts. One is Lira, 442 kilometers (274 miles) north of the capital, Kampala. Bicycles have long been ubiquitous, and many families tend to have one. Cultural norms in northern Uganda don't prohibit women from riding. While the roads in Lira town are paved, dirt paths lead into the heart of the district where farming is the main economic activity. The Buffalo Bicycle is a recent arrival. Many have never heard of it, or can't afford it. Retailing for roughly $200, it is three times more expensive than the cheapest regular bicycle — otherwise out of reach for many CHEWs, who do not yet earn a salary. The bike's promoters cite its durability in rough terrain, needing fewer trips to the mechanic as a way to save money. The Buffalo Bicycle's heavy-gauge steel frame is so strong that it comes with a five-year warranty, said Amuza Ali, a monitoring officer in Lira for Buffalo Bicycles Uganda. Abalo and others told the AP the Buffalo Bicycle felt uncomfortable to use in the beginning, with a braking system that doesn't permit carefree backpedaling. 'When I climbed on it, it wasn't that easy as I thought,' Abalo said. 'I was like, 'I am trying again to learn how to ride.'' CHEWs using the bicycles reported a 108% increase in households reached each week, and the time to reach health facilities dropped by nearly half, according to a study published in May by World Bicycle Relief. The study shows that 'mobility is not a luxury in healthcare' but a lifeline, CEO Dave Neiswander said in a statement released for the report. Diana Atwine, permanent secretary at the Ministry of Health, has urged the distribution of bicycles to more CHEWs across Uganda, saying front-line health workers save an unknown number of lives each year. Abalo received her Buffalo Bicycle from the health minister last year. One of her neighbors, Babra Akello, said she has used the bicycle at least six times already. The first was for transport to an antenatal checkup. She praised Abalo's willingness to help. The bike has also been used for emergencies. One evening earlier this year, a neighbor's 4-year-old child suffered a deep cut while playing in the dirt. With the child's parents away, Abalo transported the bleeding boy to a facility where he briefly lost consciousness before being revived. 'That bike, not me, saved the life of that child,' Abalo said. 'If that bike hadn't been there, I don't know what would have happened.'

Yahoo

9 hours ago

• Yahoo

As death toll rises, Gazans make life-risking journeys to seek food

By Nidal al-Mughrabi GAZA/CAIRO (Reuters) -Like thousands of other Palestinians in Gaza, Hind Al-Nawajha takes a dangerous, miles-long journey every day to try to get some food for her family, hoping she makes it back alive. Accompanied by her sister, Mazouza, the mother-of-four had to duck down and hide behind a pile of rubble on the side of the road as gunshots echoed nearby. "You either come back carrying (food) for your children and they will be happy, or you come back in a shroud, or you go back upset (without food) and your children will cry," said Nawajha, 38, a resident of Beit Lahiya, in northern Gaza. "This is life, we are being slaughtered, we can't do it anymore." In the past two days, dozens of Palestinians have also been killed by Israeli fire as they tried to get food from aid trucks brought into the enclave by the United Nations and international relief agencies, Gaza medics said. On Thursday, medics said at least 51 people were killed by Israeli gunfire and military strikes, including 12 people who tried to approach a site operated by the U.S.-backed Gaza Humanitarian Foundation in the central Gaza Strip, the latest in near-daily reports of killings of people seeking food. The Israeli military said there were several attempts by "suspects" to approach forces in the area of Netzarim in the central Gaza Strip, in a manner that endangered them. It said forces fired warning shots to prevent suspects from approaching them, and it was currently unaware of injuries in the incident. In an email, GHF criticized Gazan health officials, accusing them of regularly releasing inaccurate information. GHF said that Palestinians do not access the nearby GHF site via the Netzarim corridor. It did not address questions about whether GHF was aware that such an incident had occurred. Thirty-nine people were killed, meanwhile, in separate Israeli airstrikes in the northern Gaza Strip, medics said. One of those strikes killed at least 19 people, including women and children, in a tent in Shati refugee camp in Gaza City, they added. Another strike killed at least 14 people and damaged several houses in Jabalia, in the north of the enclave, medics said. There was no immediate comment from the Israeli army on those attacks. In recent days, the Israeli military said its forces had opened fire and fired warning shots to disperse people who approached areas where troops were operating, posing a threat. It said it was reviewing reports of casualties among civilians. SLEEPING BY THE ROAD Israel has been channelling much of the aid it is now allowing into Gaza through a new U.S.- and Israeli-backed group, the Gaza Humanitarian Foundation, which operates a handful of distribution sites in areas guarded by Israeli forces. The Gaza health ministry said hundreds of Palestinians have been killed trying to reach GHF sites since late May. The United Nations rejects the GHF delivery system as inadequate, dangerous and a violation of humanitarian impartiality rules. Israel says it is needed to prevent Hamas fighters from diverting aid, which Hamas denies. On Wednesday, the GHF said in a statement it had distributed 3 million meals across three of its aid sites without an incident. The Gaza war was triggered when Palestinian Hamas militants attacked Israel on October 7, 2023, killing 1,200 people and taking 251 hostages, according to Israeli tallies. Israel's subsequent military assault on Gaza has killed nearly 55,600 Palestinians, according to Gaza's health ministry, while displacing almost the entire population of more than 2 million and causing a hunger crisis. The Norwegian Refugee Council warned on Thursday that more than 1 million people were without adequate shelter, saying equipment such as tents and tarpaulins had been blocked by Israel from entering since March 1. Nawajha returned empty-handed on Wednesday from her journey to find food, flopping down exhausted on the dusty ground outside the tent in Gaza City, where she has been displaced and sheltering with her family. She and her sister have been camping by the road for the past 20 days. They say they try to force their way into the distribution site where trucks carrying aid arrive, but are often outmuscled by men, who sometimes fight over sacks of flour coming off U.N. trucks. "(When) there is no food, as you can see, children start crying and getting angry," said Nawajha. "When we are for three, four kilometres or more on our legs... Oh my... our feet are bruised and our shoes are torn off."

Bloomberg

12 hours ago

• Bloomberg

UNAIDS Executive Director: ‘The HIV Response Is in Crisis'

Winnie Byanyima says her organization has lost almost 50% of its funding, a gap that is undermining global efforts to combat HIV/AIDS. By Are we unraveling years of progress on fighting HIV/AIDS? For the past two decades, the US has led the global response to a virus and disease that have together claimed more than 40 million lives. But there are still more than a million new infections every year; with no vaccine or cure, preventing further spread is critical. This is why there was so much alarm from campaigners and experts when the US Department of Government Efficiency, led by Elon Musk, started slashing foreign aid. In an interview last month, Musk himself told me that HIV-prevention programs were ongoing. But Winnie Byanyima, executive director of the Joint United Nations Programme on HIV and AIDS, tells a different story. Her organization is one of the key bodies fighting the virus globally — UNAIDS operates in nearly 100 countries — and Byanyima says the disruption she's seeing is both real and deadly. We spoke while Byanyima was on a visit to South Africa, where the rollout of one of the most promising HIV-prevention tools in a generation is now in doubt. 'Even if I get the next batch of medicines,' one aid worker in Soweto told her, 'they may expire because the two people I had who go out and reach people in their communities [are no longer there].' This interview has been edited for length and clarity. First of all, are you able to set the record straight? To what extent has your work at UNAIDS been affected by the DOGE-led cuts to USAID? First, globally, the HIV response is in crisis. Clinics have closed. Prevention services have halted. People are losing access to lifesaving medicines. People are scared. Our work as the UN leader of the global HIV response is also affected severely. We've lost close to 50% of our funding. It came from two pockets of the United States government. So we are also struggling to stay alive. But there is a crisis and a huge disruption, the biggest since the global response was created about 25 years ago. I know that Elon Musk has doubted that these disruptions are there,[and] has even said that if they are there, he would fix them. 1 I know he has left government, but I'll be happy to go with him anywhere in Africa or Asia to show him, or take any other American official to see what the real impacts are for people living with HIV and for people at risk of HIV, like gay men [or] women and girls in Africa. In our May conversation, Musk said he did not believe many HIV-prevention programs had stalled: 'If in fact this is true, which I doubt it is, then we'll fix it.' But he also questioned the assertion that cutting USAID would result in any fatalities, saying that recipient organizations 'don't even try to come up with a show orphan' to back up their claims of saving lives. When you say the HIV response globally is in crisis, how much of that is to do with US funding cuts? How great is America 's responsibility for that situation? Huge. The United States government and US taxpayers were contributing a lion's share of the support to developing countries to fight this disease, up to 73%. You might say, why the United States? Well, it's the wealthiest country in the world, and these are the poorest countries in the world. By pulling its funding away very quickly, the US didn't [give] these highly indebted countries — that are heavily impacted by [the] climate crisis, that have huge burdens of disease beyond HIV — enough time to be able to fill the gap. 2 UNAIDS created a portal to track the real-time effects of US funding cuts in the developing countries in which it operates, including observations from officials in the field. 'My greatest fear is that we will return to the dark days of the epidemic,' says the director of UNAIDS in Zambia. But what about other donors? What about rich countries in the Middle East or other G-7 countries or philanthropists with deep pockets? There have been two main sources of funding to support developing countries [on HIV/AIDS]. One is the American program, PEPFAR, the presidential initiative, and the other is called the Global Fund, where other donors — the Europeans, the Japanese, the Chinese — all put money together and help the developing countries. When the major contributor pulls out with little notice, things collapse. That is what has happened. In South Africa, which funds 80% of its own response and has been getting US support for only 17%, I visited a clinic in Soweto and saw the impact. A man who works [there] told me, 'Even if I get the next batch of medicines, they may expire because the two people I had who go out and reach people in their communities and bring them for service [are no longer there].' He's seeing a drop in the numbers of people coming forward to get what they need to prevent or to be treated. 3 This is backed up by recent Bloomberg reporting from South Africa, which has the world's largest HIV-treatment program with 80% of 7.8 million infected people on medication. So we are seeing that even in a country that's not so dependent, there are disruptions. Even in a country where the will is so strong, like South Africa, you're still seeing a gap that is definitely going to result in more new infections and more deaths. We know from our modeling that if the gap is not filled by other funding, in the next four years we are going to see up to 6.6 million additional new infections and additional deaths of 4.2 million. And that's in addition to what we were already estimating. PEPFAR, the program that you are referring to, 4 is the responsibility of the State Department. Marco Rubio, the Secretary of State, says 85% of PEPFAR is functional. PEPFAR stands for the President's Emergency Plan for AIDS Relief. It was a US policy choice that began during the George W. Bush administration in 2003, and has since then provided cumulative funding of $120 billion for HIV/AIDS treatment. That's roughly as much as the US government spends on its Supplemental Nutrition Assistance Program (food stamps) in a single year. It isn't exactly that because the PEPFAR program on the ground is implemented by two parts of the American government, the CDC [Centers for Disease Control and Prevention] in Atlanta and USAID. Now USAID has been shut. So there's no work that was done by USAID that's going on right now, though some work by the CDC is still going on. 'I say to President Trump: You are a man who likes to do a deal. Here's a deal.' But over and above that, there has been confusion. First, the cut was a stop-work order for everything. Then, within a week — and we thank the American administration for realizing that this was going to cost lives — they said it can come back, but only some of it. We see testing and treatment coming back by the CDC. We don't see much progress on prevention. So in many places, prevention clinics where people get their condoms, their PrEP, vaginal ring, whatever — these are not open. So we do see many gaps, particularly for women and girls in Africa, gay men, sex workers and people who inject drugs. They have their special clinics; those too have closed. It seems then that you think the statement '85% of PEPFAR is functional' is inaccurate, or misleading. It is inaccurate to the extent that the impact for the very low-income countries is huge. Our own data shows us that the impact is much bigger than that. 5 We asked the State Department to respond to UNAIDS' assertion that many HIV-prevention programs supported by the US have stalled. They told us they continue to support testing, care, treatment and prevention of mother-to-child transmission, and that an estimated 85% of beneficiaries could be receiving lifesaving treatment and prevention of mother-to-child transmission. All other PEPFAR-funded services are under review. Did you have any contact with Elon Musk's team at DOGE? We appealed to him publicly. I am very loud on social media and said I'm happy to meet him and take him to see. Anyway, he's left government. We are addressing ourselves now to the American government to say, 'You started something strong.' A Republican government, President Bush, came out at a time of the worst pandemic of the century and [began] a program to save lives. Right now, there are tools that could end this pandemic, and I say to President Trump: You are a man who likes to do a deal. Here's a deal. There is an American innovation called lenacapavir that's 100% effective to stop infections. An American innovation that creates American jobs that could be rolled out and we could cut down new infections almost to zero. Why not do this? That would be another Republican president bringing a revolution on prevention. This could be a win-win. Get the Bloomberg Weekend newsletter. Big ideas and open questions in the fascinating places where finance, life and culture meet. Sign Up By continuing, I agree to the Privacy Policy and Terms of Service. It is a US pharmaceutical company, Gilead, that's behind lenacapavir, which has been through lots of trials. But there would still be an issue, wouldn't there? It is likely to be extremely expensive. Wouldn't access to the drug possibly be like antiretrovirals in their early years, when they were out of the reach of the world's poorest people? You are right. We are hearing rumors in the media of $25,000 per person per year, and [if] it comes out at that price, then it will not bring new infections down to zero. 6 When they first came out, antiretrovirals used to treat HIV infections could cost more than $10,000 a year, but they eventually became widely available thanks to the work of aid organizations. Now lencapavir promises to provide six-month protection from infection, eliminating the need to take daily pills. On June 18, Gilead said that lenacapavir, marketed as Yeztugo, has a list price of $28,218 per year. It sounds as if this has been an extraordinary rollercoaster. You had immense hope that 2025 could be a breakthrough year, and instead you spent the first half of it almost battling for the organization's survival? That's true. I'm letting people go. People who have, over 20 years, built the experience to support this response. It's sad and it's unnecessary considering the billions that are being spent on building up new weapons systems and fighting wars. My core budget was not even $150 million [a year], but now it's been slashed by almost half. It's a sad moment, but we won't give up. I'm inspired by the governments and the people in countries [that] aren't giving up. They are stretching themselves, volunteering, doing things differently. We've got to keep people alive. So we are pushing on. We will continue fighting. I read that you are having to fight on another front at this moment, a personal front. You grew up in Uganda, you served your country as a political leader before you moved into international work, 7 and your husband is a longtime opposition leader in Uganda. Is it the case that he remains imprisoned, as we speak, on very serious charges? Byanyima has had quite a career. She was a flight engineer for Uganda Airlines, a combatant (alongside her husband) in the National Resistance Army and Uganda's ambassador to France from 1989 until 1994. She helped draft Uganda's 1995 constitution, and served two consecutive terms as a member of parliament before serving in leadership roles at the African Union and Oxfam International. She became executive director of UNAIDS in August 2019. That is true, Mishal. My country has struggled through crises since independence. We thought we had turned the corner through a revolution that brought back democracy, but we've seen reversals in the last 10 to 15 years. My husband has been an opposition leader for the last 25 years. But for most of those, he's been in and out of jail — always criminalized, but always being exonerated by the courts. Last November he was abducted from neighboring Kenya and taken across the border. It's now six months he's been in jail. He hasn't been tried. For a long time he was not even charged, he was just illegally being held. He's not the only political prisoner, but we have the international human rights organizations supporting his cause, supporting that he should be released on bail, so that he can fight whatever charge they may have against him. 8 In February, Byanyima's husband Kizza Besigye was charged with treason over an alleged plot to overthrow Ugandan President Yoweri Museveni. Besigye has unsuccessfully tried to unseat Museveni — who has been in power since 1986 — in four elections. How is he and are you able to be in contact with him? We are in contact with him and able to visit him. But he's not in a good condition. He's in a tiny cell where you can hardly even sit by his bedside, there's not enough room. So yes, I am angry at how he's being treated. I'm angry at the illegality that the president has shown. The Supreme Court decided that as a civilian, he should not be tried by the military. [President Yoweri Museveni] reversed it by bringing a law before Parliament to allow civilians to be tried by the military. 'No one anywhere — in any country in the world, rich or poor — should take freedom for granted, should assume that because they're enjoying human rights, because there's rule of law at a certain point in time, that it'll always be there.' Didn't he used to be a friend of yours, President Museveni? He is a family friend. I first met him when I was little. He was always in and out of the family home. He was a friend of my parents. This is just about politics and power. President Museveni has never quite accepted the idea of being a democratically elected leader who respects an opposition and competes with them fairly. I wonder what this leads you to conclude about the nature of power and authority. Your generation knows what dictatorship was like when you were growing up, the time of Idi Amin. You ended up having to leave Uganda, you came back, and you were part of building institutional governance. What are the lessons of how to build a nation to ensure structures that safeguard people's rights? You raise a very important point. No one anywhere — in any country in the world, rich or poor — should take freedom for granted, should assume that because they're enjoying human rights, because there's rule of law at a certain point in time, that it'll always be there. You can have reversals. Sudden reversals or slow reversals, but reversals do happen. You must always be working as a citizen, doing your duty to protect your constitution, to defend the rule of law, to defend the human rights of others, not just for yourself. May I close, Winnie, by asking you what gives you strength? To be battling on these two fronts — one professional, one personal — at the same time, it would take a lot out of anyone. It is tough, but the truth is that I have lived a life of struggle. I don't say my life was always rough. I've had, and I still have, very many happy moments. But at every point I have had to be a part of struggles, to make lives better — for myself and for others. What's happening to me on the personal front, what's happening on the professional side, I see them all as a struggle for justice. Justice for my husband, justice for people living with HIV, justice for those who are denied their rights because of their sexual orientation, because of who they are. So I live day by day and think everybody has their load to carry. And that's mine. Mishal Husain is Editor at Large for Bloomberg Weekend. More On Bloomberg