How Attorneys in Ukraine Can Use Health Law to Save Lives
By Naomi Burke-Shyne & Olena Kucheruk
Valeria Kolomiets, a lawyer in Western Ukraine, has witnessed firsthand how access to justice can be critical to a patient’s health. In late 2016, Kolomiets was notified that a young man held in a local detention center was suffering from drug-resistant tuberculosis and urgently needed second-line medications to manage his condition. However, the detention center’s administration had refused to send him to a hospital, keeping him in their own medical unit instead.
Not every lawyer is well equipped to recognize the significance of their clients’ medical needs and health-related rights, but Kolomiets had recently been trained in health law by the Ukrainian Legal Aid Foundation (ULAF) and knew what to do.
She first appealed to the detention center’s administration, requesting all documentation related to her client’s medical treatment. While awaiting their response, her client’s condition began to deteriorate quickly, and staff from the detention center’s medical unit had to resuscitate him.
Kolomiets urgently sought out an independent doctor to treat him. Finding someone was a challenge, though, because many doctors in Ukraine avoid treating detainees and prisoners for fear of reprisals from correctional administration. Kolomiets eventually found a doctor willing to examine her client—but neither she nor the doctor were allowed to enter the detention center’s medical unit.
Kolomiets still persisted, recording all aspects of her client’s case and preparing to submit multiple appeals to human rights bodies. Once the medical staff at the detention center learned what she was doing, they finally transferred Kolomiets’s client to a hospital that could provide him with the care he needed.
This case is just one of ULAF’s health law program’s many success stories. Founded in 2011, ULAF seeks to improve access to free legal aid and ensure high standards of justice in Ukraine. One of ULAF’s goals is to use legal tools to promote access to health rights, especially for clients who are held in closed settings such as police stations, jails, or prisons.
A survey of Ukrainian lawyers conducted by ULAF in 2013 found that although the vast majority of lawyers felt unable to properly assess their clients’ medical needs or use legal tools to obtain appropriate care, an estimated 60 percent of clients needed medical attention.
This is one of the reasons why ULAF offers training workshops on health law. The goal is to help more lawyers provide legal and health-related support to their clients. In the interest of ensuring that patient feedback is heard, ULAF also works to develop key partnerships between patient advocacy groups and members of the legal and medical communities. ULAF also networks with legal clinics housed at university law faculties so that the next generation of lawyers will be better equipped to address the health needs of their clients.
ULAF’s work has been assisted by important reforms to Ukraine’s legal aid system. Since 2013, Ukrainian police are required to report all arrests to a legal aid center so that detainees who cannot afford the services of a defense lawyer can still receive free legal advice. This reform represents a powerful advance in access to justice and the rule of law.
However, a 2015 survey of Ukrainian law enforcement officers by the International Renaissance Foundation confirmed the challenges ULAF identified in 2013. According to the report, an estimated 54 percent of individuals in detention experience serious health problems. The majority of officers did not consider the provision of medical care to be part of their duties and reported that they would only make efforts to ensure access to health care when a person’s life was in danger.
Although the medical units of detention centers and prisons in Ukraine employ health care professionals, these staff must comply with the orders of the correctional administration. For this reason, many cases of inadequate or inappropriate medical treatment and denial of care go unreported. Lawyers with training in health law are rarely available in these cases.
ULAF’s ultimate goal is to ensure that vulnerable groups have access to legal assistance that helps them exercise their right to health. As Kolomiets’s story shows, lawyers can play a vital role in improving their clients’ access to justice and access to health care—provided they have the necessary training and support.
It is essential, therefore, that influential members of Ukraine’s medical and legal communities organize together to demand policymakers elevate and support health law. In some cases, this additional expertise can be the difference between life and death.
Until October 2017, Naomi Burke-Shyne was a senior program officer working with the Law and Health Initiative and the International Harm Reduction Development Program.
Olena Kucheruk is the public health program manager at the International Renaissance Foundation in Ukraine.