Why after the term in the women’s colony to return there of their own free will? To protect women’s right to health in prison. The story of Natalia Minayeva
“I was amazed at what a prison it was”: Kazakhstan vs Copenhagen
– We once had a working visit organised to a prison in Copenhagen, and I was amazed at what a prison it was! One and a half beds, one computer. There is no internet, but you can study different programmes. There is a lot of free time, why sit there? – says Natalia Minayeva, a Kazakh activist from the city of Temirtau who fights for the rights of people in prison.
Natalia has something to compare with. She spent 12 years in prison: drug use and criminal connections brought her behind bars three times since 1998. And not just behind bars, but in a strictly isolated barracks in the women’s colony for HIV-positive people in the village of Koksun, where convicts from all over Kazakhstan were brought. Not long before, the country had been hit by an epidemic of drug use and afterward HIV infection. The colony administration was afraid of women with HIV; they were forbidden to have contact with other prisoners and even had to work in a separate garden.
– We were separated, everyone looked at us as if we were on death row, no one knew anything about HIV,” Natalia recalls.
She was luckier than other prisoners with HIV, who did not live to see this day, dying of AIDS, tuberculosis or overdoses. Not only did Natalia survive, but she also found her freedom – and now she helps women where she was herself to survive and believe in themselves.
Today she is the head of the public association “Nursenim” and has more than 10 years of experience in helping vulnerable groups in Kazakhstan. As a paralegal, Natalia consults on issues of human rights violations by the police and seeks access to medical services for vulnerable groups. As a member of the National Preventive Mechanism for the Karaganda region, Natalia has visited closed and correctional facilities in Kazakhstan for monitoring purposes
Natalia also came on a human rights mission to the colony where she once served her sentence – in Koksun. And she will return more than once – to support the “girls” (as she calls them) before their release and to convince those who do not want to treat their HIV infection to take ARV therapy.
The right to health in Kazakhstan’s prison: progress and challenges
Ten years ago, the situation of HIV-infected prisoners in Kazakhstan was almost catastrophic: there was virtually no access to prevention, diagnosis and treatment of chronic diseases, including HIV and hepatitis. Prisoners with these diagnoses were discriminated against.
Thanks to human rights activists like Natalia and her colleagues in the National Preventive Mechanism (which has been operating in the country since 2014), the situation with access to health care in places of detention has improved. Today, the majority of prisoners receive ART and treatment for tuberculosis.
But problems remain.
– Hepatitis is not treated in prisoners, but many want it. The colony simply does not have enough escort forces to take them to the clinic for diagnosis. It is almost impossible to get an appointment with a specialist, – says Natalia Minayeva. – We had a meeting with the Human Rights Commissioner and with the deputies of Kazakhstan in 2024, and we raised this issue there. We were promised that hepatitis B would be diagnosed and treated in the colonies.
Recently, the mother of one of the prisoners called Natalia and literally cried into the phone that her son had HIV, hepatitis C and progressive cirrhosis and that “he would die there”.
– We contacted the Karaganda regional health department to take immediate measures for his treatment. Then they called and said that they were preparing documents for his release for health reasons. He was released, I met him when he was already free, he started ARV therapy!
In her reports on visits to correctional facilities, Natalia also noted other obstacles faced by prisoners in need of medical care. For example, in some institutions, HIV-positive people were not given ARV drugs and had to wait in the freezing air for more than an hour for a nurse with pills. Given that HIV denial is already widespread among prisoners, Natalia notes, it is unreasonable to create additional barriers to treatment adherence in the colonies.
And what really needs to be implemented in all colonies and prisons without exception is peer-to-peer counseling on issues of HIV, hepatitis, addiction.
Natalia and her colleagues in the field of protection of prisoners’ rights and assistance to people with HIV are planning to expand their work to other regions of Kazakhstan. In the second decade of 2025, meetings are planned with the Human Rights Commissioner of the Republic of Kazakhstan, the Ministry of Health, the Ministry of Corrections, and the Ministry of Probation.
– As a community, we will meet with government officials and raise the issue of the need for peer-to-peer counseling in each region of the colony.
Natalia is one of those peer counselors.
Peer counseling + motivational package = “light in the window”
– When I come to the colony, I tell the girls: “I am the same as you! I was in the same colony,” says Natalia Minayeva about her work in Koksun.
Her work is approved by the Department of Criminal Enforcement. Before leaving, Natalia contacts the colony’s education and training department and asks to prepare a group of women for the meeting. She focuses on those who have used drugs, are serving sentences under “drug” articles, and are living with HIV.
– I communicate with them so that when they are released they do not relapse into drug use, crime, so that they know that you can live with HIV, – explains Natalya.
Natalya’s work is supported by the Global Fund, so she does not come to the “girls” empty-handed.
– The Global Fund has given us some money for motivational packages for the women and for phone cards so they can call home, – says Natalia. – I asked the girls what they needed most. They said they didn’t need tea or coffee, but they did need creams and shampoos. We need to buy these items from the list for the next visit.
At first, the women are wary of strangers, seeing “their” person in front of them with a gift, but gradually they open up to Natalia and share their concerns and problems. According to all the rules of counseling, Natalia guarantees the confidentiality of the participants, including the prison staff. But their common fears are known.
Women leaving prison often have nowhere to go. Without family support, there is a high risk of “breaking down” and using drugs, many simply do not know where to get treatment for addiction, where to go for rehabilitation, others do not have the money for it. Natalia remembers all these worries from her own experience and tells the women where and what kind of help they can get once they are free. She gives them her phone number, and when they call, she helps them find a place to live and a job, fill out paperwork, and resolve legal issues.
– The girls at the colony tell me, “When you come, it’s like a light comes through the window,” Natalia recalls of her previous trips to the colony.
A particularly important goal for Natalia is to reach out to HIV-negative women.
– In the colony where I go, five out of thirty HIV-infected women are not on treatment. I explain to them: “Do you understand that you have a virus in your blood that is multiplying and growing? In three or four years you will get pneumonia, your immune system will not be able to fight this disease. I have friends who did not take the therapy, they are all in the cemetery. You still have eight years to serve, and what will happen to your health in those eight years? Any comorbidity can be fatal if HIV is not treated.
Natalia says she will not rest until each of these five recognizes the need to take ART:
– I have had HIV for over 20 years, I have a zero viral load. I am a living example for them!
The information campaign “Restriction of Freedom ≠ Restriction of the Right to Health” emphasizes that people in prisons should have the same access to health services as people in the community. Organized by the Eurasian Movement for the Right to Health in Prisons, the campaign emphasizes that restricting freedom should not mean restricting the right to health. Health is a universal right that belongs to everyone, regardless of their social status or place of residence.
Media support: virus off