Ukraine’s lavra clinic is operating on borrowed time

Ukraine's lavra clinic is operating on borrowed timeThe Lavra clinic is located in central Kiev, right next to the famous Pechersk Lavra, -the easy-to-recognize landmark with the iconic golden cupolas, also known as the Kiev Monastery of the Caves.The Lavra clinic is a site unlike any other in Kiev, or in Ukraine for that matter. Some 1,500 AIDS patients come through its doors to receive treatment every year. For many, Lavra is their last hope for receiving treatment. Svetlana Antonyak, the extraordinary woman with fighting spirit who runs the clinic, is a real management, training and humanitarian whiz. Since the beginning of the epidemic, the care providers at the clinic have seen thousands of patients. Unfortunately, too many of them died because they did not get timely access to treatment. For Svetlana, every day is a new battle in the fight against the disease and, for the past two years, the fight against bureaucracy. Because, as Svetlana puts it, the clinic is in «survival mode». «The monks next door have never been very supportive of the fact that we are treating AIDS patients here, including homosexuals, sex workers and injecting drug users. They really just want us to leave. But things have gotten worse in the past few months, as the call for us to leave has gotten louder and louder; we have been told other buildings are available outside the city that are much larger. But there is no doubt that a real estate project is the true reason behind the campaign to get us to leave». Svetlana has tears in her eyes as she talks about «her» clinic and «her» patients.The clinic was built in 1911 with donations from the residents of Kiev. When it first opened its doors, it was used to treat soldiers injured in the First World War; it served the same purpose during the Second World War. It was then used as a treatment center for infectious diseases; polio patients, among others, were treated there. When the AIDS pandemic hit in Ukraine, the clinic was a logical choice. Once again it changed and adapted.

Based on the latest figures released by UNAIDS two weeks ago, Ukraine has the highest prevalence rate in Eastern Europe and Central Asia (0.78% of the 15-49 age group), with 230,000 HIV-positive individuals. Injecting drug users (IDUs) have been particularly hard hit by the epidemic. In 2011 alone, IDUs accounted for 31.1% of new HIV cases. Currently, only 28,000 patients are receiving antiretroviral (ARV) treatment, while 170,000 people are in need of the treatment, according to figures from the WHO.
And so, Svetlana has a fight on her hands. «In Ukraine, we need real prevention policies to be implemented at the highest level. Prevention is not on the agenda because it is not a priority for the government. But how can we doctors engage in serious dialogue when we have seen twelve Health Ministers come and go in the past ten years. The first AIDS patient was treated at the Lavra clinic in 1995. We put patient care protocols in place and, most important of all, we established a training center for physicians and care providers that now serves as a benchmark. Funding is provided by the Global Fund. Thanks to the training center, we now have trained personnel in every region in Ukraine. That in itself is a huge victory. The other victory involves the patients who come to us when they are at death’s door. Sometimes they don’t even know what is wrong with them. And for us, it is a real triumph to see them leave the clinic. They know that they will have to take drugs for the rest of their lives, but at least they feel better and they can return to work, or in the case of children, they can go back to school. We have the know-how to save lives and to make a child smile again. I only wish that I could save the Lavra clinic, but that battle is going to be a lot harder to win».