Meerim Bolotbaeva: Our clients are people living with HIV, TB patients,drug users, LGBT people, sex workers. People who need a lot of support, prevention, care, psychological, social and financial aid. People who need us to be present. Photo: Private archive

Bishkek and other districts of the Kyrgyz Republic are under emergency state since the end of March 2020 due to the Covid19 pandemic. This means a strict restriction of movement and self-isolation, necessary to stop the spread of the new coronavirus. But for the UNDP/Global Fund Project and its partners, it’s a real obstacle to continue helping their clients: patients with TB, people living with HIV, and key groups of the population. Meerim Bolotbaeva from the UNDP/Global Fund Project conducted a survey among partners to know how this situation impacted their work and shares the results in this blog:

We at the UNDP/Global Fund Project, together with our partners, work with the most vulnerable groups of the population to prevent and treat diseases. Our clients are people living with HIV, TB patients,drug users, LGBT people, sex workers. People who need a lot of support, prevention, care, psychological, social and financial aid. People who need us to be present.

And the main part of this job requires continuous permanent contact with these clients – to have them tested, provide new sanitary equipment, conduct prevention trainings and one-on-one consultations… So how do we make sure this doesn’t collapse during the emergency state? How can we make sure that these populations, who are already vulnerable, who have a weak immune system, continue to be protected in the face of a new global pandemic? This is the most important time to be there for them, but we can’t be there physically.

Our project conducted a survey among partner NGOs and organizations at the beginning of the state of emergency in April, to know how their work was impacted by this new, unexpected situation. What marked me the most was when our partners pointed out that a lot of our clients didn’t even have a passport, which is necessary to go outside under the emergency state. Can you image how difficult the situation is on these people? Especially considering level of stigma and discrimination by law-enforcement structures towards key population such as drug users, SWs and ex-inmates.

We have among our clients many people living in very difficult financial conditions. Some of these are people who have been sick for years and unable to work. Some of these are people who have been abandoned by their family because of their disease or sexual orientation. Some of these are people who were just released from prison and have nowhere to go. Some of these are people who have nothing to eat for tomorrow.

Due to the state of emergency, our clients have difficulties going to the health facilities to receive consultations, diagnosis or their daily treatment. They have even more difficult financial problems and do not know whom to turn to. This, and their chronic illness, make them so much more vulnerable than others to COVID-19.

We continue to do everything we can to help them, provide timely prevention, diagnosis and treatment. But of course this has become more difficult under the emergency state and the pandemic. 53% of our partners said that they had a decrease related to coverage of their activities. Unfortunately, they are able to help less people than before. 34% said they could not go to their office, and 31% said they had problems with communication.

Of course we are doing everything we can to overcome these obstacles. But I think that the Covid19 pandemic will teach us to rethink our work models. There are many positive lessons to take from this situation: concentrate on local solutions, call for solidarity and fundraising, and restructure our work. We need to think about innovative methods of prevention, treatment and consultation. Going to a health clinic every day is a real burden in an ordinary life, and becomes impossible in this situation. This is the best time to think about the future. We need to use digital solutions like video observed treatment more often. We need to trust patients and communicate with them via our smartphones or online platforms. We need to build sustainable at-home treatment delivery systems. And we need to ensure comfortable working conditions for outreach workers and peer consultants. COVID-19 is forcing us to change. So let’s change for the best and on the long term.    

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