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A small shrine outside the Hospital for Epidemiology and Infectious Diseases in Kiev.
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A testament to women's resilience
Ukraine's government has been slow in responding to the epidemic, partly due to the stigma associated with HIV/AIDS and partly due to the costs involved. The fear of discrimination prevents many women from seeking medical treatment. In the past, people who acquired sexually transmitted diseases were put in sanitariums. And Ukrainian drug users and sex workers could also be imprisoned for breaking antidrug and antiprostitution laws.
Yet optimistic inroads are being laid by a few courageous and determined Ukrainian women. These dedicated frontline workers -- some doctors, some social workers, some counsellors, some HIV positive themselves -- make tireless efforts to combat the AIDS epidemic, drug addictions and sex trafficking of women plaguing their country. They are a testament to women's resilience. They have stepped up to the plate where their government has failed them.
One of these women is Dr. Svitlana Antonyak, head of the Lavra AIDS clinic at the Hospital for Epidemiology and Infectious Diseases in Kiev. Antonyak and her team of four female doctors spend days and nights beside their patients' beds, despite earning miserable salaries. (The discrimination faced by AIDS patients extends to their doctors.) Antonyak's ward of 26 inpatient beds provides diagnosis, counselling and medical care and antiretroviral (ARV) treatment for patients from four to 60 years old. More than 2,000 others are registered with the clinic, receiving treatment on an outpatient basis. Currently, 265 people are receiving ARV medication, funded by the Canadian International Development Agency (CIDA) through the Global Fund to fight AIDS, Tuberculosis and Malaria.
Antiretroviral drugs slow down the replication of the HIV virus in the body. Not a cure, they nevertheless protect people whose immune systems have been weakened by HIV from becoming ill from other infections. ARVs must be taken every day once a person's immune cell count drops to a dangerous level -- a gradual process that can take several years. Under Ukraine's law on the prevention of AIDS, every citizen has the right to free medicine, yet there are no mechanisms in place to provide the drugs. So, on the whole, in Ukraine there is very little access to ARV therapy.
Dealing with psychological issues
One of the hardest parts of Antonyak's job is dealing with psychological issues. "Some of our patients become very depressed and no longer have a desire to live," she says. "My female patients, who are not only living in this country's economic instability but also living with HIV, are very brave. This is a very heavy load for them."
One such patient is 34-year-old Iryna, who found out by chance that she was HIV positive in 2004 while donating blood. Iryna was not a drug user, nor had she worked in the sex trade. She had, however, been living with a boyfriend who used intravenous drugs and has since died. When recalling the day she found out her positive status, her eyes instantly well up with tears.
"Emotionally, I was terrible. I thought I was going to die. I remember when I left the hospital with my mom -- colours just faded and I was in a fog," she says, wiping away fresh tears. "I feel regret for the old days and despair for the future. All I thought of was how people would be afraid of me."
Fortunately Iryna received the psychological support she so desperately needed as well as proper medical assistance to treat herpes, a common co-infection of HIV. "Dr. Antonyak spent hours both day and night supporting me," she recalls. Inspired by her doctor, Iryna now works as a social worker at the Centre for Social Services for Youth with HIV/AIDS in Kiev, providing 36 clients with medical checkups, food rations and other social services.
Photographs by Heather Buchan. Produced with the support of the Government of Canada through the Canadian International Development Agency.
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