You're reading: Patients risk death in Kremlin-controlled Donbas over restrictions of medication

After the Ukrainian government imposed special passes for all traveling to and from separatist-controlled areas, the restrictions didn’t interrupt delivery of food and other goods.

But the measures, designed by the Ukrainian government to force Russia to take responsibility for the three million people living under control of their proxies, interrupted vital medical supplies for as many as 10,000 of the most vulnerable residents. These are the people in the Donbas living with HIV, tuberculosis and drug addicts.

Some 37 drug addicts relying on opiate-substitution therapy have already lost their medication this month and 450 more risk losing it soon, international health nongovernmental organizations warn. They could end up dying, which is what happened to 80 former patients on methadone therapy in Crimea after Russia annexed the peninsula in March. Russia doesn’t support this form of therapy.

“It became prohibited to treat with methadone in Crimea, but here we were ready to continue the program and the government refused to supply us with medication,” said Valentyna Pavlenko, Donetsk regional coordinator of International HIV/AIDS Alliance in Ukraine, told the Kyiv Post by telephone.
The war-torn Donetsk and Luhask oblasts are among those the most severely hit by communicable diseases. Just in territory controlled by Russian-backed separatists, some 16,500 people with HIV and 2,300 people with tuberculosis, including 500 people with a drug-resistant strain of TB, according to Ukrainian official statistics.

Viktor Salkov, a Health Ministry spokesman, said that all supplies to separatists-controlled areas, including delivery of medication have been terminated by Ukraine’s government.

“People who are receiving special therapy may get it on Ukrainian territory. That is the only way,” he said.

But doctors and social workers say those who most need the medications are the poorest and least able to travel outside the war zone.

Yulia Drozd, doctor of Donetsk-bases site of substitution therapy, said supplies ran out on Jan. 5. “So 24 people were left to their own,” Drozd said, with some resuming use of street drugs.

In about a month, some 155 people receiving methadone therapy in Donetsk alone may also lose their medications. “But with methadone, the withdrawals are harder and may last for over a month,” Drozd said.

Drozd said that 60 percent of her patients have HIV and 20 percent TB. If they stop methadone therapy and go back to drugs, they will become transmitters. She said some patients were ready to travel from Donetsk to Ukraine-controlled territory daily to get a dose of methadone, but no one let them pass through checkpoints.

Using her personal contacts, Donetsk’s Pavlenko managed on Jan. 28 to send through numerous check-points a parcel with antiretroviral medication for 13 children with HIV living in orphanage in Kramatorsk.
Donetsk’s own supplies of antiretroviral medication are running out in March, forcing Pavlenko to travel to Ukraine-controlled territory to get new supplies of these pills.

But she is not sure the Ukrainian government will give her a permit to leave Donetsk for this purpose and notes the process takes up to 10 days. Pavlenko doesn’t think it will be possible to bring methadone drugs. “It’s impossible to carry drugs without special convoy,” she said.

In Donetsk regional TB hospital, doctors are rationing medicine. “It’s scary to think what will happen to our patients in three or four months,” Dr. Oksana Serdiuk said.

State medical workers haven’t received their salaries for months because of the Ukrainian government cutoff, but they keep working.

Serdiuk said that, with the new restrictions for crossing the front line, one of her patients recently couldn’t go back home to Kramatorsk after his treatment was finished. “So now people usually don’t even try to leave Donetsk,” she said.

Andriy Klepikov, head of International HIV/AIDS Alliance in Ukraine, said last autumn his organization purchased emergency treatment drugs worth $4.6 million. “These medications are being delivered everywhere apart from the ATO (anti-terrorist operation) zone,” he said.

Unlike medication against TB and HIV, Ukraine doesn’t pay for methadone therapy out of its state budget. These drugs are supplied by foreign donors. The donors only ask the government to allow methadone supply.

Physician Drozd admits that her patients will probably go back to drugs. “Patients are dying in front of us and we cannot help them,” she said.

Kyiv Post staff writer Oksana Grytsenko can be reached at [email protected]