KYIV – The old green-and-white bus drives slowly through a quiet Kyiv suburb while its occupants argue about the best place to stop. Some want maximum visibility, others suggest keeping a safe distance from a nearby school. They’re probably right to think that students’ parents would object to the vehicle’s contents: an industrial-size box of condoms, alcohol swabs and a large bag of hypodermic needles.
In any case, the school has closed its doors for the weekend. The doctors, volunteers and social workers on board the bus have come to teach the neighborhood outcasts a lesson in survival, using a decidedly alternative syllabus.
Tatyana Logynova, a Kharkivsky district social worker, calls it the ‘bus of hope.’ Its purpose is to educate intravenous drug users about the threat of infectious diseases, encourage them to seek treatment and, most importantly, slow the rapid spread of AIDS among addicts through a controversial needle distribution program. ‘Society sees drug users only as enemies,’ said Logynova. ‘But when we teach our young people how to protect themselves against sexually-transmitted diseases and AIDS, I think we can help them change their whole lifestyle for a healthy one.’
The bus is one of two mobile ‘trust points’ that patrol three outlying Kyiv districts twice a week distributing leaflets, advice, condoms and clean hypodermic needles under the auspices of the United Nations Children’s Fund (UNICEF) and the city’s youth social services department. As it parks, the bus is transformed into a clinic by bright posters stuck up in the windows offering confidential advice and information about AIDS for young people. Conspicuous in bright yellow vests, volunteers stand outside and give out leaflets and condoms to young passers-by at each stop.
On this cold evening, however, interest is low. Old people squint up at the posters on the windows curiously and shake their heads before moving on. Some teenagers giggle hysterically as they handed condoms along with leaflets explaining their use.
Free needles are not advertised, but are available inside the bus. The vehicle has only been running since March 25, and the staff are still trying to overcome drug users’ fears of police harassment. Volunteers have distributed an average of 10 needles during each trip, according to Logynova.
‘There isn’t enough advertising of this project,’ said Logynova. ‘We must inform our users and our population more. They must believe in this project.’
Proponents of the free needle program, modeled on one launched successfully in Odessa a year ago, insist that it is the only way to tackle the spread of AIDS among drug users and beyond them to the community at large. Kyiv health and law enforcement officials were tracking more than 500 cases of AIDS among drug users last year, up from 42 in 1995, according to UNICEF. A UNICEF survey of 150 intravenous drug users in Kyiv found that 99 percent had used dirty needles at least once.
Educating drug users about the dangers of infection is not enough, volunteers say, because addiction often overpowers common sense.
‘Even if someone knows I’ve got AIDS, if they’ve really got a craving for a high they’ll inject themselves anyway with my syringe,’ said Valik, a 15-year-old addict who has come inside the bus looking for help in quitting his habit. Valik does not have AIDS, but he has contracted viral hepatitis, another disease the UNICEF program hopes to curtail.
‘If anyone uses my needle after me they’ll get hepatitis,’ said Valik. ‘I don’t want anyone to use my needles, and I try, no matter how bad I’m feeling, not to use other people’s. I don’t throw them away, I keep them with me.’ In two weeks on the road, the staff of the bus have already won over some regular visitors. One is Oleg, a 20-year-old drug user befriended last week by Logynova, who persuaded him to take a clean needle. He promised to come back, and sure enough he does, this time seeking legal advice to get him out of trouble with the police.
Oleg is clearly impressed with the non-judgmental attitude of Logynova and her staff.
‘I like it here,’ he said simply, when asked why he has come back.
Other drug users are suspicious, and fear that approaching the bus could get them in trouble with the police. Walking a short distance from the stopped bus, Logynova encounters 30-year-old Eduard, who confesses to a seven-year drug habit and accepts a leaflet, but refuses to accompany her back to the bus.
‘People are just afraid, they think all this stuff is done specially by the police,’ he said. Eduard complained of perpetual harassment from police officers, who as soon as they see needle marks on his arms, ‘just senselessly start beating me up, they don’t say a word about treatment or help,’ he said.
Although the staff manages to convince him that the bus is not a trap set by the cops, Eduard remains scornful of the project, saying it cannot change the general attitudes of the authorities and of a society that favors imprisonment over treatment.
‘Of course you know and I know addicts are sick people who need treatment, but do they know that?’ he asks. The fears expressed by Eduard and other drug users may be well-founded. Although the program has been approved by the Justice Ministry and city authorities, officials from the Interior Ministry’s anti-drug unit have said they may send additional police to points on the bus routes to crack down on drug dealers they expect to gather there. So far the bus has not attracted any unwanted attention, either from police or from drug pushers, and it is up to drug users to ensure it remains that way, said volunteer Ira Drach, a 24-year-old teacher.
‘If anyone comes to us without any drugs on them, no one will bother them,’ she said. ‘We talk to the people who come here about this. If they buy drugs here, then they’re just making problems for themselves.’
Drach acknowledged that some of the drug users who come to the bus are not interested in quitting, and stressed that changing their minds is not the program’s chief objective. ‘People come here for clean needles,’ she said. ‘It’s not addiction we’re fighting, that’s not our problem. Of course we’re against addiction but our primary goal is to combat AIDS.’
But volunteers are more than happy to counsel addicts on treatment when they ask for it, and many have, they say. The bus’s library of literature includes addresses for Sociotherapy, the city’s network of clinics and rehabilitation centers, and the evangelical organization Varnava, which also runs a rehab center.
Drach has friends who are addicts, and she pushes a strong anti-drugs message.
‘People want to try drugs, like they want to try everything,’ said Drach. ‘but I wouldn’t advise them to try drugs. I would tell them what it leads to, because I’ve seen that myself.’
That advice comes too late for Valik, who said he first experimented with drugs when he was 14 because all his friends were already using them.
‘Like all addicts I thought one time couldn’t lead to addiction,’ he said.
Valik boards the bus at its last stop, near Rembaza, a cluster of hostels on the outskirts of the city which takes its name from a nearby bus repair depot. There’s hardly anyone around, but the volunteers are warned that the neighborhood is a dangerous one and told not to stray too far from the bus.
Valik does not want clean needles. He and his friend want help giving up drugs.
‘We’re really, really interested in treatment,’ he said. ‘We’re already taking drugs now not for a good time but to avoid a bad time. We really want to get out of this.’ Drach gives him the phone number of a local clinic, but now that he’s found a safe haven in the bus, Valik is reluctant to leave.
‘Where are we going?’ he asks. ‘Have I got to get off now?’ Unfortunately all the staff can offer is some advice, a needle and a condom rather than lasting help. Then the bus rumbles on, leaving Valik and his friend on a dark, deserted street corner.
Valik hangs on tight to a piece of paper bearing the coordinates of a local treatment clinic.
‘I’ll definitely call this number,’ he says before leaving.
