Treatment v. incarceration
by Wyndimarie Anderson
Harm Reduction Project
You hear this debate all the time. The truth is for some people it can feel like one and the same for many reason and the recent tragedy in Russia reminds me that we have to make sure our treatment centers do not become prison like (again)….

In Moscow this week, 46 women were killed in a fire in a drug treatment facility.
Apparently, the 44 patients and 2 staff were trapped between the fire and a locked gate which led to their deaths.

Locked gates in a drug treatment facility? From everything I have been able to read so far this was not a facility housing inmates from the criminal justice system. Why were there locked gates? And why didn’t the staff have the keys to open the gates?
Our work to educate people about the need for health care and drug treatment includes making sure that the programs and facilities offered are not substandard or just one step removed from jail. We don’t need steel bars to treat a drug addict. We need treatment. And we need access to that treatment.

(Yes, we need a lot more, but for the sake of this posting I’ll stay focused on that)
Here is a comment from the Russian Harm Reduction Network calling for an investigation into the fire: http://www.healthdev.org/viewmsg.aspx?msgid=9E66ED94-2DD4-4D97-AFFA-5CC7B380CA3F

The Russian Harm Reduction Network (RHRN) and the International Treatment Preparedness Coalition / Region of Eastern Europe and Central Asia (ITCPru) express deep condolences to the families of people who died in the fire in the drug treatment hospital #17 in Moscow, as well as to those who were injured during the fire and to the hospital personnel.

On December 09, 2006 the Office of the Procecutor General of the Russian Federation announced initiation of criminal cases under two articles: malicious destruction of property and disregard of fire safety resulting in death. While we support the need for a just an unbiased investigation into this tragedy, our collective expertise as activists and professionals working in the areas of drugs and HIV/AIDS shows that the problem is as systemic as it is individual. RHRN and ITCPru assert that the cause of the tragedy is rooted in the inhumane and ineffective organisation of drug treatment in Russia, and is not merely due to the negligence of separate individuals.

"Conditions within drug treatment facilities in Russia remind more of prisons than hospitals," - says Vitaly Djuma, the Executive Director of the Russian Harm Reduction Network, which unites providers of harm reduction services to drug users from all over Russia.
"In the rest of the modern world this approach to treatment was banned decades ago. Cells, bars, insensitive personnel, indifference to the lives of their patients - all these add up to cause of the tragedy. The problem is not of a just one particular hospital, this is the problem of the whole system."

Specialists and activists agree that whatever the results of the investigation, we shouldn't blame selected individuals be them patients or personnel of the hospital. We especially denounce placing the blame on a woman in severe pain and suffering, for breaking the fire. The distribution of discriminative and speculative disinformation in press before the end of the investigation is yet one more part of the systemic problem that creates general public antipathy towards the victims.

"Blaming separate individuals means closing one's eyes on the fact that the whole system of drug treatment in Russia is absolutely ineffective, inhumane and discredited, - says Gregory Vergus of the International Treatment Preparedness Coalition, an association which unites HIV activists from around the world, including those from Newly Independent States and the Baltics.

"What is called 'narcological assistance' in this country in fact isn't assistance at all.

Join the Harm Reduction Project in signing this petition asking for a full investigation of what happened to the clinic in Russia. Treating addicts like throw aways or criminals cannot go unnoticed in any part of world… the deaths of these 44 women do matter.