“Not moralization, but an expression of friendship:” fight for the health and human rights of drug users in St Petersburg

People who use drugs often face stigma and discrimination when trying to get basic health care. Based in St Petersburg—a city where 70% of HIV cases are the result of injecting drug use—the Humanitarian Action Fund fights for the health and human rights of injecting drug users, as well as other marginalized groups such as sex workers, migrants, and street children. Sasha Tsekhanovich, the founder, describes Humanitarian Action’s approach as “not moralization, but an expression of friendship.”

The organization, a grantee of OSI’s International Harm Reduction Development Program, operates a mobile clinic on a refurbished bus that travels to areas where drug users live and buy drugs. For the last decade, the bus has been a light in the dark, offering clean needles and syringes, alcohol swabs, condoms, psychological counseling, blood testing, basic medical services, and information about safer injecting, HIV, and hepatitis.

 A Light in the Dark: Health Services for Drug Users in St Petersburg(A transcript of the OSI multimedia piece) 

Sasha Tsekhanovich: Drug users have a lot of problems, because this is a group which is rejected by society. They are first of all sick people. The addiction is a sickness. It's because of their sickness that they are criminals.

And a drug user has enough of moralization. All people, all the society, all the world around, always moralizes them how to live, saying, “The way you are living is bad, you should change your life, you should be better.”

All drug users are first of all human beings. Harm reduction is maybe a place of rehabilitation of the dignity of a human being.

Text slide: Humanitarian Action’s harm reduction bus makes nightly stops to provide needle exchange and other health and social services to drug users.

Tsekhanovich: We are trying to mobilize all that we can see here in St. Petersburg. Now, I should say, the harm reduction bus became a part of our city landscape.

We are not in the option of moralization because you will not be able to do something constructive, for the destiny of a drug user. And we have to try to find a complex approach to the problem.

A very scrupulous work. You enter here in a private world of a person, and you have to find a right language that would be accepted not like a moralization, but like an expression of friendship.

Text slide: Syringe exchange reduces the risk of needle-transmitted epidemics such as HIV or hepatitis.

Tsekhanovich: Syringe exchange in harm reduction is a way to establish this trust between the team and the patients or clients. And this good contact helps us to go further in pushing their reflections about what their lives are. This is just the beginning of the motivation to think about a possibility to change their life.

So, it begins just the first step safer injection, but it is a very small step, and maybe the simplest step. On this long way which maybe will end by quitting drugs, when you see all these oceans of human pain, what we are trying to do is maybe nothing.

In spite of this, we are trying to do these small nothings because we know that these small nothings lead to something more important, for these human persons with whom we work.