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Welcome to the third newsletter of Bridging the Gaps - Health and rights of key populations.
        IN THIS EDITION:



Bridging the Gaps wants to achieve universal access to HIV/STI prevention, treatment, care and support for sex workers, LGBT people and people who use drugs. These key populations are typically 10 to 20 times more likely to become infected by HIV while only 8% have access to HIV services. In our approach we want to create added value by focusing simultaneously on all 3 key populations and on the crossovers between them in one single programme. Through our newsletter we keep you updated about the activities and results of Bridging the Gaps, which consists of 21 key population projects in 16 countries as well as 4 global advocacy projects.
 
In this third edition of our newsletter we proudly present to you our first publication ‘Universal Access? Not without Rights!’. The publication highlights some activities and results of the first phase of our programme and looks at the challenges that are still ahead of us in reaching universal access for key populations. With this newsletter we further take you on a journey to Eastern Europe and Central Asia.
Read the stories of our AFEW colleague Ruslan Myatiyev, who visited some of our PUD and LGBT projects in Kyrgyzstan and Tajikistan, but also of our new bloggers Inna and Natalia both working for NGOs that received a small grant from our partner ITPC that will be used to advance access to treatment for key population communities in their respective countries. We also have a special guest blog from Kakha, who is in fact working for one of the partners in our PUD project in Georiga, but who conducted an outreach training for LGBT in Ukraine.
 
We hope that the results achieved by and the personal stories of our outreach workers and other bloggers are an inspiration to those of you working with key populations anywhere in the world! Enjoy reading!


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UNIVERSAL ACCESS? NOT WITHOUT RIGHTS!

Achievements of Bridging the Gaps – Health and Rights for Key Populations

Implementing social media and internet-based interventions for LGBT in Brazil; increasing life skills of young women and girls involved in sex work in Uganda; introducing mobile CD4 count machines to efficiently screen PLHIV who need Antiretroviral Therapy (ART) in Pakistan; addressing forced drug treatment centres across Eastern Europe and Central Asia; and developing a global advocacy agenda for key populations living with HIV. These are just a few examples of activities and results of the first phase of the Bridging the Gaps programme. 

In September 2011, five Dutch NGOs, four global key population networks and more than 70 in-country partner organisations started working together in the programme Bridging the Gaps – Health and Rights for Key Populations. Main goal of this partnership, which is funded by the Dutch Ministry of Foreign affairs, is to achieve universal access to HIV/STI prevention, treatment, care and support for key populations. Two years into the programme, we have collected some of our main achievements thus far in this publication ‘Universal Access? Not without Rights!’.

LESBIANS, GAYS, BISEXUALS, AND TRANSGENDERS: WE DO SERVE THOSE PEOPLE!

In Kyrgyzstan, a country in Central Asia, the  local LGBT movement has established a certain position in socio-political life. However, social stigma and discrimination against lesbians, gays, bisexuals, and transgenders still exist on many levels in this largely Islamic country. The fear of being revealed sometimes takes over the desire to defend one’s human rights. However, Kyrgyz LGBT community members and organisations are heading in the right direction to assert themselves as integral part of society. The idea to create a legal entity that would unite all LGBT community members and defend their rights arose in 2004 in a popular café in Bishkek, when a group of like-minded friends was celebrating someone’s birthday. When after a toast two girls kissed, the waiter sent the group out of the place by saying ’We do not serve such people’. A year later this initiative group became NGO ’Labrys’. Now, it is the oldest organisation in the country to work with LGBT people. Labrys collaborates with COC Nederland within the Bridging the Gaps programme.
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SAKHI TAJIKISTAN: HELPING PEOPLE WHO USE DRUGS RETURN TO SOCIETY

In every country where AIDS Foundation East-West (AFEW) implements the Bridging the Gaps programme there is usually a number of non-governmental organisations (NGOs) that work with key populations. This fosters competition and, therefore, improves the quality of services they provide to clients. Every service provider has something to attract clients. Some offer comprehensive health services with a pool of friendly doctors of various expertise available by phone, others boast of having a lawyer or a social worker who can speed up the process of issuing new identification and disability allowance, and solve similar social issues. The NGO Sakhi works mostly for people who use drugs in Tajikistan. Sakhi smoothly runs different services. Its major advantage, however, is that it teaches people who use drugs a skill, and helps them reintegrate in society.
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ONE DAY AT AYAN DELTA: VISITING A SMALL DROP-IN CENTRE FOR PEOPLE WHO USE DRUGS IN TOKMOK, KYRGYZSTAN

Maxim Naydenov (22) shows me the traces of injections on his arms. Although he does not shoot heroin for already half a year, the traces are still very visible and do not seem to be going away soon. This concerns Maxim a lot, as since recently he is dating a girl and has serious plans with her. “By the way, do you know if methadone affects the sperm?” he asks me unexpectedly while telling about his girlfriend. I shrug and shift my glare to Olga Novikova, a doctor at the non-governmental organisation (NGO) Ayan-Delta in Kyrgyzstan. She prescribes methadone here since 2007. Olga watches another client taking the medicine, hands him water to wash it down and pulls out a book from a shelf. As the morning proceeds, more clients show up in this small drop-in-centre in the heart of Tokmok, a small town located 60 kilometers away from Kyrgyzstan’s capital Bishkek.
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NGO RANAR: THE FIRST STOP ON THE WAY FROM PRISON

NGO Ranar is located in the outskirts of Bishkek, the capital of Kyrgyzstan, in a private house with a nice kitchen garden where its clients grow vegetables for their own use. The clients are former prisoners and people who use drugs; many belong to both groups. Today, the house hosts thirteen people, but in wintertime this number doubles as many people have no permanent place to live when they return from prison. There are no rules in this house, besides an elementary code of conduct, and there is no control over persons’ life and behaviour. People learn about the place while still in prison – in some of the prisons, Ranar has its own social workers who prepare prisoners for release. They come here consciously with a clear goal to start a new life. And Ranar is there to offer help.
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From our blog:

SUPPORTING SEX WORKERS LIVING WITH HIV IN TAJIKISTAN

By Inna

My name is Inna, I am 30 years old and I live in Dushanbe, Tajikistan. I am a leader at the organisation Dignity and a member of the sex workers network Shah-Ajym. In the evenings, I sometimes work as a sex worker. It is difficult for me to be in a community where people are not sex workers. Many people disapprove of me. Some sympathise with me, but ask stupid questions, and then I desperately want to run away. But even within my own community, sometimes I am confronted with discrimination – because I am living with HIV. Some girls inform my clients about my status, and then I earn less.

In Tajikistan life is quite challenging for sex workers, particularly for those living with HIV. I get HIV treatment and feel healthy. But many do not have of a passport or any official registration and, therefore, have no access to treatment.
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SPIN PLUS TAJIKISTAN: A HOME THAT STILL ATTRACTS

A 40-year old well-built man, Murod, comes to the non-governmental organisation (NGO) SPIN Plus almost every day. This NGO is one of the eleven partner organisations of AIDS Foundation East-West (AFEW) in Tajikistan that implements the Bridging the Gaps programme. SPIN Plus focuses on harm reduction and advocacy of human rights of people who use drugs, and also provides various health related services to sex workers, people living with HIV and vulnerable women. Murod wears a neatly ironed shirt, his mobile phone rings every five minutes and he gives orders to someone on the other end while playing with an Opel key in his hand. Although he does not take drugs for two years now, he prefers not to be identified by his real name as he is afraid to lose his job when his boss knows his story.
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THE STORY OF MAKS: SUPPORTING LGBT PEOPLE IN KYRGYZSTAN IN DEALING WITH VIOLENCE

Kyrgyz Indigo is one of the organisations working together with COC Nederland in an LGBT project in Kyrgyzstan. Since 2010, the non-governmental organisation (NGO) Kyrgyz Indigo has been providing various services to the LGBT community in Kyrgyzstan. Amongst others Kyrgyz Indigo conducts voluntary counselling and testing; refers community members to a doctor; provides condoms and lubricants; conducts training on health care and human rights; and is involved in advocacy.  Ruslan Myatiyev of AIDS Foundation East-West (AFEW) meets Danyar Orsekov, Executive Director of Kyrgyz Indigo, This is Ruslan’s story.

Personal security of LGBT people is taken seriously here. With numerous reports of discrimination and violence against them coming in almost every day, Kyrgyz Indigo cannot do otherwise. Danyar and I meet a young man who got beaten two nights before when he came out of a gay club and headed home. Maks believes he has been beaten because of his sexual orientation.
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KYRGYZ INDIGO: SAFE HAVEN FOR LESBIANS, GAYS, BISEXUALS AND TRANSGENDERS

This is the second part of the story about Kyrgyz Indigo, an LGBT organisation in Kyrgyzstan and one of the two local partner organisations of COC Nederland. Ruslan Myatiyev of AIDS Foundation East-West visited the non-governmental organisation (NGO) in June 2013 to get a glimpse of the kind of work this NGO is carrying out within the Bridging the Gaps programme, funded by the Netherlands Ministry of Foreign Affairs. The story of Maks is not the worst that can happen to an LGBT person. Daniyar recalls the most outrageous case about six months ago in Osh, a city in the south of Kyrgyzstan.  An open trans girl was sexually harassed by a group of men who started to threaten her with a gun, when they found out that she was a trans girl. As a result of severe stress she cannot walk anymore.
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CHALLENGES AND ASPIRATIONS OF THE LGBT COMMUNITY IN TAJIKISTAN: A VISIT TO EQUAL OPPORTUNITIES

Organisations that work with LGBT people in Central Asia, and in most other countries of the former Soviet Union, have common challenges: stigma and discrimination against their clients; frequent police raids on spots where they get together; and lack of laws that protect the rights of LGBT people. Tajikistan experienced a civil war from 1992-1994, which left a trace in the souls of the people. From its population of around eight million people, 1.5 million migrate abroad to earn some money for their families. The society is quite conservative and more than 90% of the population is Muslim. People have difficulties to accept gays and lesbians in their families. Though the community of gays, lesbians, bisexuals and transgender people is rather big in Tajikistan, gay clubs are non-existent and other clubs refuse to rent out their space for gay parties. A handful of LGBT organisations must be very cautious to ensure security to its members when organising parties in private homes.
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From our blog:

SEX WORKERS STANDING UP FOR SEX WORKERS IN UKRAINE (NATALIA)

By Natalia

My name is Natalia Isaleva and I’m 35 years old. I live in Ukraine with my husband and 14-year-old son. I’m now pregnant again and am expecting a new daughter! We don’t choose the life we’re born into, and because of my circumstances I ended up as a sex worker. I started this work in the year 2000 in Russia, staying there a few years before returning to Ukraine.

While working in the sex industry I experienced both violence and violations of my rights. Sex workers in Ukraine, as in Russia, face a lot of stigma and discrimination. And because sex work is criminalised, violence and violations are also often committed by officials, police and the medical profession. For example, rapists are often not held accountable for the crimes they commit.
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Guest Blog:

SPECIALISTS AND OUTREACH WORKERS FROM UKRAINE, KYRGYZSTAN AND TAJIKISTAN SHARE KNOWLEDGE ON REACHING OUT TO LGBT

By Kakha Kepuladze

Earlier this year, together with a colleague from Ukraine, I carried out an outreach training for LGBT. Eleven years ago, when I was just starting my work in the Georgian non-governmental organisation (NGO) Tanadgoma, I had to closely deal with the LGBT community. These people were marginalised and ’rejected’ under the Soviet ideology, which had a heavy pressure on views and human relations. However, the organisation and the people I have worked with helped me to understand that human beings are not to be segregated into ’right ones’ and ’wrong ones’. We are part of one society and all the fears are due to the absence of information, crippled understanding, and myths, which we take for granted without giving them a second thought. In Georgia, HIV  and sexually transmitted infections (STI) prevention activities among vulnerable groups, including men who have sex with men (MSM), are conducted by Tanadgoma, the only organisation in this field here.
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