Immense social upheaval
Rampant drug abuse and sex trafficking have made Ukraine the site of Europe's worst AIDS epidemic, as political turmoil and unemployment have frayed its social fabric. But some women have decided to stand up and save themselves and their daughters -- and to prove that courage can create hope.
Devastating news for a young mother
Tatyana had no idea of the devastating news she was about to learn as she sat in a Kiev hospital bed cradling her newborn baby girl in January 2003. When the nurse uttered the words, "You are HIV positive," Tatyana simply stared back, bewildered. She had heard whispers about HIV but had no idea what it actually was. As the nurses explained, the 16-year-old came to understand the severity of her fate: she was infected with an incurable disease in a country lacking the resources to properly treat her.
Tatyana was not a drug user, nor was she sexually promiscuous. When she was first tested for pregnancy, she also had a blood test, which came back negative for HIV. However, when she was back in hospital months later to deliver her baby, new blood tests determined that she was HIV positive. What accounts for the discrepancy? "I remember the nurse at the first blood test coming into the hospital room with an unwrapped needle to take my blood," she says in a raspy voice, her head bowed and fingers fidgeting nervously. "I was too shy to ask the nurse if the needle was clean because she was the nurse and I thought she was the expert." Tatyana suspects she contracted HIV from that dirty needle.
After learning what HIV actually is, Tatyana fell into a deep depression. "I thought I would be completely isolated, that nobody would like me," she says. Sadly, hers is a fate that is becoming all too common for women in Ukraine, a country in the midst of an AIDS epidemic. The doctors, social workers and volunteers who help Tatyana and others like her are trying to stem the tide of an immense social upheaval that is threatening their country's health.
A collective sense of hopelessness
In 1991, just five years after the catastrophic Chornobyl nuclear explosion, Ukrainians gained independence from oppressive Soviet rule and sweeping economic reforms were promised. All too soon, however, widespread corruption plunged Ukraine into poverty and despair. Escalating unemployment and widening inequality between the ruling class and the remainder of the population led to a collective sense of hopelessness. It didn't take long for criminal networks to flood the country with illegal drugs, readily available through the porous borders of Central Asian countries that connect the heroin fields of Afghanistan with Ukraine. Cheap heroin, in turn, fuelled rampant drug abuse. The crime rings also zeroed in on the desperation of millions of unemployed by targeting the country's most vulnerable citizens: unemployed women willing to take on any type of work to support themselves and their families. Thousands have been lured into the sex trade via bogus job offers and sold into slavery in Turkey, Russia, Germany and other countries.
Because it is illegal to possess an unauthorized needle in Ukraine, narcotic users share the few needles they have, spreading the HIV virus. In the sex trade, vulnerable young women are often denied the right to use a condom. So today Ukraine is not only battling drug and human trafficking epidemics but also an escalating HIV epidemic. The virus is poised to spread to the general population: A recent United Nations AIDS report predicted that by 2010, six per cent of Ukrainians will have HIV. (In Canada the rate is 0.3 per cent.) Official statistics from UNAIDS estimate that 360,000 of Ukraine's 47 million people are already living with HIV/AIDS, but many Ukrainian medical experts, including Dr. Svitlana Komar, chief consultant for the Ukrainian AIDS Centre on Pediatric Issues, believe the actual number is five or six times greater. Ukrainian women account for 40 per cent of those infected, and without access to antiretroviral drugs, these women are at risk of having babies born with HIV, too.
"The more I work in this area," says Komar, "the more I realize it's mostly a social, economic and political issue rather than a medical issue. Our health ministry is our national disgrace," she says. "Nongovernmental organizations should not be substitutes for the state, but they are."
Photographs by Heather Buchan. Produced with the support of the Government of Canada through the Canadian International Development Agency.
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