The moment she saw the police, Natalya Rybina’s heart sank. Last June Natalya’s organization, Sotcium, was conducting free HIV tests and other services for drug users in Bishkek, Kyrgyzstan to mark the International Day against Drug Abuse and Illicit Trafficking. The police were positioned outside, threatening to detain anyone who tried to enter. “If even one drug user is caught near our office,” she explained, “we will never enjoy the full trust of our clients and be able to reach them with prevention activities.”
This problem isn’t limited to Kyrgyzstan. Research from countries as varied as the US, Mexico, Ukraine and China suggests that police abuse can increase the health risks that groups like sex workers and drug users face, leading to unprotected sex, unsafe injection, and HIV infection. Driven by arrest quotas, abysmal salaries, and knowledge that drug users and sex workers have limited recourse from abuse, police see these communities as easy prey.
In Kyrgyzstan, it is common for police to “stake out” or even raid organizations that provide services to sex workers and drug users. They regularly arrest and harass program clients who are attempting to access clean needles, opioid substitution therapy, condoms, or an array of other vital health services. Given their lack of social, political, and legal capital, both drug users and sex workers are at high risk of police abuse and extortion. Based on the 2010 national Behavioral Surveillance Survey data for Kyrgyzstan, one third of all sex workers and two thirds of injection drug users reported either experiencing or being threatened with physical abuse by police in the last 6 months alone. Yet less than one third of those affected were willing to report the abuse.
This widespread police hostility is no secret. Though sex work is currently neither a crime nor an administrative offense in Kyrgyzstan, the government recently considered amending Kyrgyzstan’s Administrative Liability Code to make prostitution punishable by fines of up to 1,500 soms (US$30) and imprisonment of up to 15 days for repeat offenses within a year. On February 18, the proposed amendment was withdrawn. Though there was no official communication explaining the government’s decision, Dastan Bekeshev, the Parliament Deputy, indicated that there was concern that introducing a penalty could lead to even greater police abuse of power against sex workers.
“What kind of a detective are you if you sit in ambush near the methadone center? What are you trying to achieve this way?” asks retired police colonel Alexander Zelichenko, who is appalled by this type of policing. As former advisor to Kyrgyzstan’s state drug control service in a time when the HIV epidemic was skyrocketing, he learned through experience that these kinds of policing tactics serve only to drive marginalized groups further underground away from critical treatment and services.
This realization prompted Zelichenko, Open Society Foundations and other advocates to work together to persuade Kyrgyzstan’s Ministry of Interior to take steps to align policing with public health efforts targeting marginalized groups. In 2003, the ministry issued Instruction 417, ordering police across Kyrgyzstan to refrain from interfering with public health programs, requiring them to conduct occupational safety activities to prevent exposure to infectious diseases, and mandating coordination between police and local level HIV prevention professionals to increase access to health services for marginalized groups. Over the last several years, the public health organization AIDS Foundation East West has coordinated with sex worker and drug user groups across the country to develop and conduct police trainings for existing police and academy cadets, educating them about the ministry’s order.
A recently published article in the journal Health and Human Rights, analyzes the impact of Instruction 417. In this first study of its kind, a team comprised of academic, and civil society researchers shows that law enforcement policies can help bring policing practices in line with public health efforts for sex workers and injection drug users. Police awareness of Instruction 417 was linked to better awareness and acceptance of harm reduction programs and better understanding of booking procedures, which are seldom followed.
Back in Kyrgyzstan, the positive effect of Instruction 417 is palpable. In Sotcium’s case, Natalya called one of the officers who had been instrumental in training others about Instruction 417, and within 10 minutes the police outside the center vanished. The officer even called back several times to ensure that Sotcium’s event went smoothly.