Bogdan Zaika, All-Ukrainian Network of People Living with HIV/AIDS, Kiev

November 2009

Russian transcription by Olga Zelinska

Translation and editing by Sophie Pinkham

Bogdan Zaika:  I work in the All-Ukrainian Network of People Living with HIV, as a senior specialist in the treatment department.  At present I work…as a paper pusher (laughs).  I work on program activities and grant management.  Now I am in charge of a project on rehabilitation.  I’ve been working at the Network since…January 28, 2004 was the day I first arrived at the Network’s central office.

Sophie Pinkham: And before that, what did you do?

BZ: Oh…I worked lots of places.  What happened was that from 1997 to 2001 or 2002 I took serious drugs.  Not even since 1997, since 1996 or 1995.  I don’t remember exactly.  But I took hard drugs…though I quit occasionally. And that was sort of my main occupation.  Everything else was on the side.

Then because of the state of my health…I had to stop.  I had a fractured spine…A compressed fracture…I was in Odessa.  I could walk, but my legs felt bad.  When I shot up I didn’t even feel the needle.  But I got around somehow.

I remember when I went to the neurologist.  He told me to use some ointment.  Only the sixth neurologist thought of sending me for an x-ray.  And when the x-ray technician saw it, he said—lie down!  Right away.  Then they told me that my spine was fractured.  I had to lie down.  I couldn’t walk.  Because it could break, so I couldn’t walk at all.

And here [pointing], I had another tumor.  When I started taking care of my spine, right away they found this tumor.  And by then I already knew that I had HIV.  And hepatitis on top of it…I was diagnosed with hepatitis and HIV in 1997.  And in 2002 I started having all these health problems.  Under my jaw, I had a malignant tumor—lymphoma.  They started giving me chemotherapy.

They didn’t want to take me [for surgery].  That is, they told me that in Ukraine there are two professors who can do this surgery, so that I could walk.  Otherwise it’s not possible. I went to the first, he examined me and said, “Yes, I can do it, but I’m not going to take you.  With your history, for everything else, I don’t know what to do.”  He said, “I’m a young professor, I’m a careerist.  And what if you die?  After the operation?”  He said, “I don’t want to spoil it…

SP: He said that directly?

BZ: Yes, but I’m grateful to him for it.  Say—I don’t want to spoil my work record…In terms of prognosis, you are a very bad patient.  So I’m not going to take you.  And he rejected me.

I went to the second…he was old, seventy, a professor.  First he did an operation on the lumbar part of my spine, through the abdominal cavity—not cutting from the back, but getting to the spine through the stomach.  And he looked at all my medical history—hepatitis and everything else…He said, “It doesn’t matter to me what else is wrong with you.  I take responsibility only for this operation.  I’ll do the operation, great, and anything that happens afterwards, that’s for you to worry about.  Whatever doctors you’ll need in connection with your other illnesses—I don’t know.”

He did the operation.  When I left the hospital after a month they made me a corset, a plastic thing…they sent me over to oncology.  And there I had a second operation.

Seven days after the second operation my parents came and took me home.  I lay at home.  The oncologists had prescribed chemotherapy.  So I wouldn’t have to go anywhere, I made an agreement with a nurse who lived nearby, in a neighboring house, she worked at the oncological dispensary in Chernigov.  And she gave me chemotherapy at home—she came and set up the drip.  The doctor came to me at home.  I had chemotherapy for half a year, once a month.  The “tough” kind.  I went bald…And chemotherapy is also taken with hormones.  They gave me a pack a day of prednisolone.  My sense of taste changed…I ate everything.  And after five minutes I wanted something completely different.  Total craziness. And I was still bedridden.  There was my head, there was my torso, thin legs, thin arms, a corset.  We had to expand the corset by thirty centimeters because I was like a bubble.  [Laughs.]

Then they tried for a long time to get me to stand up.  I had been lying down for four months already.  It was time to stand up, to walk.  But it hurt.  It was hard to stand, and scary, my legs didn’t listen.  So I was lazy.  They asked me for a whole month to stand up and walk.  I have one friend, Zhenya, who came to see me and we walked around the lake.  And everything was already normal when I went around it.  It’s three kilometers.  After about three months I could go around it normally, on my own.

And I sat at home, never went anywhere, never saw anyone.  I didn’t call anyone.  All my friends were users.  I didn’t want to use.  And I didn’t know who else to call.  And then Artur [Osipyan] and Seryozha Musienko called me, completely by accident.  I already knew them from Odessa.  We met there.  And they said they were in Chernigov and we should meet.  They came over, sat down, we ate.  They said, “Why are you sitting at home?  Come with us, we’re working here.”  And they started telling me about the Network.  That they’d come on a regional development visit, so that Chernigov would open an office of the Network.

Then I started talking to my parents about this.  My father and mother made a categorical statement that I could do whatever I wanted wherever I wanted, except that in our home town I could do nothing connected with AIDS or drugs.

I agreed and told the guys about this.  They answered that I could always come to Kiev.  They left.  They came back after a month.  I said, “Yes, I’m coming.  When should I go?”  This was in the end of December.  They said—let’s talk after the New Year.  On the 28th they called and asked me to come that day.  I packed my thingс—I had only one black plastic bag—and came to Kiev.  And since then I live in Kiev.

SP: Was it hard for you to find money for thе operation?  It must have been very expensive.

BZ: All this “pleasure” [ironic], these two operations, cost me, to put it bluntly, a car.  A Zhiguli.  And I had about a third of the amount.  The rest came from my parents.  It was just lucky that we had the money.  If we hadn’t—nothing would have been done.

The hospital room cost $100.  For them to find a place.  You have to pay for everything.  Plus, the situation then was that there were no services.  The only one I could find was Doctors without Borders from Odessa, over the phone.  They were the only ones who could consult with the doctor who was treating me after the operation.  A month and a half after the operation my temperature still hadn’t fallen, and they [the local doctors] didn’t know anymore what to inject me with, which antibiotics.

Ira Borushek and Natasha Leonchuk came to see me in the hospital.  Then they agreed with Doctors without Borders about consultations, but practically nothing happened.  There was the Lavra [Clinic].  I didn’t know about Lavra then.  The central office only opened in this period, when I was bedridden after the operation.  The guys started working there and invited me to join them.

SP: How did you meet Ira and Artur?

BZ: I first met Ira when we were in rehab together, in 1999.  We celebrated the New Year together in rehab.  That’s how I met her.  And from then on we met from time to time, kept in contact.  I came to Odessa, lived there for a while—for half a year, a year.  Then I went back and lived in Kiev.  And I saw her there.  And I kept up a relationship with Artur and Sergei, too.  We also met in Odessa.  Someone introduced me to Artur, and I met Musienko when he worked in the rehab center, and I ended up there as a patient.  But after that we started spending time together.

SP: Did you go through rehab many times?

BZ: In terms of drug treatment—I don’t know [where to start].  They coded me.  In my native town they didn’t take you anywhere except the insane asylum.  That was the only institution where you could stay normally. They gave me loads of injections, I was in a constant stupor.  Our insane asylum—it’s a…colorful place.  The village [where it’s located] is called Khalyavino—twenty kilometers from the city.  When you go there, on the way you pass a sculpture of three bears.  So people call the madhouse “Three bears.”  [Laughs.]

There are about thirteen sections there.  There’s the closed section, where there are bars on the windows.  Orderlies.  You can’t leave.  You take walks inside the courtyard, so you can’t escape.  That’s where they keep violent people, or those who are witnesses in a court case, or suicidal soldiers.  There they decide whether to commit him, or whether to try him for desertion…And violent cases, dangerous for society—they’re also held in the closed section.

I was only in the closed section.  Those services cost about 130 hryvnia a month.  At that time that was nothing.  You could put yourself in under any name—James Bond, if you wanted.  You paid 130 hryvnia and they kept you for a month, fed you for a month.  For that, the condition was that if you came in anonymously, whoever committed you had to come and get you out.  No one else could take you.  So I could put you in, pay $20 a month, call you Svetlana Nikolaevna Ivanova.  And you’d be in the insane asylum.

…Of course, it’s not honest.  It’s the doctors’ wages.  They take alcoholics, drug addicts for treatment, people who behave badly.  So parents can take their son in, pay him [the doctor] and he [the doctor] will keep him for a month, two, three…some people take in their husbands.  Some people take their wives.  Some people come on their own.  So there are services on demand.  Plus here [in the hospital] there are…barbiturates.  Sleeping pills.  Neuroleptics.  They weren’t sold freely here.  If you were in drug withdrawal, the insane asylum was the best place.  If you were coming out of a drinking binge and you were afraid, the insane asylum was also the best place.  There were always orderlies, IVs, medicine to keep you from panicking.  So people came.

I went there and turned myself in.  Alone.  Usually for two weeks.  The last time my parents took me.  They put me in, so they had to take me out.  After two weeks I told them—it’s OK, I’m better, come and get me!  And they said, “No, it’s not necessary!  We’re so fed up with you, that 130 hryvnia a month is nothing for us.  And you’re under supervision.  Nothing will happen to you.  It’s cheap.  And when you have a plan about what to do afterward, then we’ll talk.  Maybe we’ll come and get you.”  I got out of the insane asylum after a month and a half—my parents took me.

I was there four times.  But…it was a scary place.  Even if the services were needed. Out of 100 people in the ward 10 were “commercial” beds, where there were drug addicts and alcoholics.  90 people were crazy.  And everything that went on there…The orderlies who lived in the village got really low wages, and to put up every day with 100 crazy people—most of them [the orderlies] were not normal people.  You had no idea what to expect from them.

Ten people were drug addicts who were always doing something stupid.  When I came my friend came too, and we stole all the sleeping pills in the place.  In the evening, when they did the injections, one managed to steal.  We stole the soldiers’ uniforms and boots and traded them for moonshine.  When we had no money and nothing to trade, we found crazy people with gold teeth.  We’d knock out their tooth, take the crown and trade it for moonshine.

Then came new soldiers, and immediately after they arrived we stole all their boots.  Four pairs.  They complained to the head doctor, and the whole ward was searched as they looked for the boots.  They searched for two and half hours and they couldn’t find them.  [Laughs.]  The doctor came and said that everyone was going to be tied up.  So everyone was tied to the bed.  Everyone was injected with Haliperidol, a complicated medicine—to describe it simply, if you want to do something, you will never in your life do it.  You can’t drink—you’ll miss your mouth. Your head gets stuck when you try to turn it.  And they usually give this medicine to crazy people along with “correctors”, that stop you from freezing up, and you can do something.  But they gave us all Haliperidol without “correctors” and injected us with “gray”.  Another unpleasant medicine.  I don’t remember what it’s called.  An oily fat, injected when it’s hot, in four places—in your buttocks and under the shoulder blades.  It makes your temperature rise to 40 degrees, your head hurts, you shake, you have chills.

SP: Why did they do this?

BZ: To make us give back the boots.  We just stole boots and they did all this to get the boots back.

Then they turned over the beds.  You could stand the beds there up on their legs, and then turn them over.  And if you were attached, you’d be hanging from the straps, facing the ground, but you wouldn’t fall… But we had to drive them to this.  To tie us up like that.  It wasn’t that the staff got pleasure from torturing us.  We had to drive the orderlies and the head doctor to the point that they tied us up.  For the most part, those kinds of “executions” are only allowed when someone’s been beaten, especially with cuts and blood.  They put you down like that for physical violence, mutilation, suicide attempts.  You have to do something stupid.  I could talk about the insane asylum forever…

SP: What other kinds of experiences did you have in rehab?

BZ: I was in “Steps” in Odessa.  One…two.  Two times.  The first time my parents sent me and paid.  The second time I went myself, without money.  I came with the girl I was living with at the time, Inna.  Between the two of use we had $500.  That was all.  And that was including the fact that we wanted to rent an apartment in Odessa for a month, and the money that was left was for living and for rehab.  We came to “Steps.”  We started talking with Akhmenov…

Ira Borushek came, she was working as the financial director at that time..she said—don’t worry.  You don’t need money.  Go lie down, lie down for a week, and we’ll deal with it.  So I went [to “Steps”] and stayed there…for half a year.  For half a year I got free rehab.

They “coded” me.  But the coding didn’t work.  My parents took me there…and I said, where’s the guarantee?  Let’s make a deal—you code me, and if I go and shoot up and nothing happens to me, give me back my money.  [Laughs.]  He said, “That’s it, I don’t code drug addicts, only alcoholics!”

SP: Will you explain what coding is?

BZ: I also did coding.  We had a business.  There were three of us.  One doctor, an anesthesiologist.  One was a typical Charismatic [a religious sect] alcoholic, but it was…a success story.  And I also did a publicity campaign.  We went around the town.  In the beginning we showed people who’d been helped.  We talked about it.  And then the doctor came.

«Coding» is autosuggestion.  The person forces himself to believe that if he does something he’ll die.  And if he himself believes this, then he won’t do it.  He controls himself with all his strength and doesn’t do it.  Sometimes they give injections to frighten them.  For example, they inject sodium oxybutyrate into the person’s vein.  And then they make him drink thirty grams of vodka.  Then the butyrate takes effect.  He’s frightened.  They tell him—drink again and you’ll die.

SP: That’s coding?

BZ: Yes.  Some people even get capsules implanted.  And they say—we’ve implanted a capsule in you.  And either you have to pull it out, or tell us how long to code you for, and we’ll put a temporary capsule in you. And a lot of people believe it.  But from the beginning I knew it didn’t do anything, that it was all a trick, and that the capsule was just gelatin.  So I wasn’t coded.

SP: Did they do coding in “Steps”?

BZ: No, no.  In “Steps” it was, in my opinion…the only path to…well, pulling yourself out of dependence, from drugs, from whatever…all that.  It’s a personality change, a change of your system of values.  That’s the key.  There’s no other path.  That is, either you trade in your personality or you change what you already have, but the second way is easier.  You break the old one, clear it away, and make another.  All rehab programs have the same goal—to break down the old personality as quickly as possible and make something new, also as soon as possible.  A program’s results depend on its success in these two processes.  What happens is that if we take away drugs, we take away not just a chemical substance, but a whole way of life.  Everything in life was subordinated to the attainment of the object of desire.  And that’s all!  So lots of time is left over.  A person can’t not use, not return to his favorite activity, the only one he likes.  Nothing is possible unless he changes.

SP: And what do you think about substitution treatment?

BZ: About substitution treatment?  I think that in general we have very few services for injecting drug users.  For drug users in general.  I think that at the present time we need to offer much more than just rehab programs that, at the present time, are non-governmental, and completely separate.  And they’re all, the majority of them, are commercial.  To tell the truth.  With the exception of Christian centers.  Although many Christian centers are also commercial enterprises.

Substitution treatment’s coverage is also very low.  And substitution treatment suits some people, while rehab centers suit others…There’s demand for each type of program.  There’s no panacea.  Some people don’t like substitution treatment.  Some people miss the dirt, the action, whatever.  Some people can’t do it, some have to steal.  Some people are more interested in the way they live.

And very often, people who give up drugs give up everything and start a new life.  A completely new person.  Sometimes that’s the only road to success.  And to get to that is difficult.  Some people get to it through centers, some on their own…But you can’t argue with the statistics. Only 20% of users can stop using street drugs for a year or more.  Thanks to substitution therapy, and 5% from rehab programs.  That’s all.  And the rest are people for whom there are still no services.  They don’t stop.  And so they will die from drugs.  Unfortunately.

SP: How did you start taking drugs?

BZ: Well, first I tried drinking. But I can’t stand alcohol.  I started smoking.  It was hard to get anything to smoke.  And then someone gave me advice: Try some opiates and then smoke a little on top of it, and it will be great.

I tried it.  And it so happened that at that moment opiates were all over the place.  They were available everywhere and sold everywhere and cost pennies.  And it was fashionable in the 90s…

Shooting up was in style.  Criminal credibility.  Everything was there.  And during this wave, I tried it and then I went to the seaside, to Bulgaria.  For a long time I didn’t understand why I wasn’t sleeping, why I was sweating, nauseous, why my nose was running and why I was throwing up.  I talked to my friends in Ukraine, complained about my health, and they said, “Don’t worry!  You’re not sick.  It’s just withdrawal.  That’s it.  How long has it been since you took a break?”  I said—about three months, probably, I’d been shooting up every day. And then I left.  I didn’t even suspect that I was in withdrawal.  So that’s how I felt it for the first time.

And now from all those people, from that big group we had after high school, probably 30 or maybe 40 people, only three or four are still alive.  All the rest passed away.  And almost all of them died from overdose or from some HIV-related illness.  Sepsis, tuberculosis, all the rest.  Those who are still alive are in prison.

SP: What’s your family like?  What are your parents like?

BZ: My parents are great people.  I love them very much.  I’m very grateful to them…after I stopped using, my parents regained their trust in me, probably after about five years; then they stopped looking into my eyes, stopped hiding money from me, valuables, whatever, gave me house keys.

My mother is the director of a school…my father is a lawyer and business owner.  My father has three degrees and my mother has two.  They’re smart. I don’t know how I turned out the way I did.  Bad company.  I went astray.

I studied in an institute but dropped out half a year before getting my diploma.  I only had half a year left, I’d already finished four and a half, but I was so drained by opium that I couldn’t drag myself through another half a year…

Now the relationship is different. I shot up in Chernigov, I was visible.  I was a kind oф fallen character.  A drug addict who was always stealing, always involved in something, police, all around me.  Then I disappeared.  I wasn’t there for a long time.  About five years.  And then I appeared, already a successful young man.  I came from Kiev.  And to my surprise I learned that I had already been buried.  Everyone said: “Yes, he’s dead.”  And the majority of people who knew me but not well, just to say hello, don’t even associate me now with the person I used to be.  Most of them only now, after knowing me for a long time, start asking, “What?  You used to be like that?  Really?”

I do routine work, but that’s what’s necessary now.  Of course, sometimes I don’t want to do it.  But it’s necessary.  And they pay me good money, I’d say.  I wanted to leave the Network…but right now I understand that it’s my organization and no matter what happens, they won’t throw me out on the street.  And I go there and I’m at home.  Even if I’m completely losing it.  There’s nothing terrible in that.

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