Yanina Stemkovska is an activist from Poltava who has been working with people who use psychoactive substances for over ten years. She is well aware of how the needs of this community have evolved, the barriers that existed prior to the war, and how they have worsened since 2022. Today, Yanina is the regional coordinator of the All-Ukrainian Association of People with Drug Addiction (“VOLNa”) and the director of the CO Eastern Resource Center of the All-Ukrainian Association of People with Drug Addiction “Meridian”. She is also a peer-to-peer consultant in the VirusOFF emergency aid project, funded by ViiV Healthcare Positive Action. In this interview, Yanina openly shares her personal story, her path into volunteering and activism, the realities of working with the community during the war, painful examples of discrimination, and what is most lacking today.
— Yanina, why did you choose the path of activism? What was your main motivation? And if we look at the last three and a half years of the war, has that motivation changed?
— If I start with my main motivation, I’ll be honest: when I began doing this, there was no high-level ideology behind it. It was a “personal” issue — my husband and I. We are from the community ourselves, and after being on opioid substitution therapy for a long time, we had to visit the dispensing site daily. For a year, two, three—it was still bearable while we were resocializing. But when we got more or less back on our feet, it became clear: we were chained to Poltava by our medication. A trip left or right—even going to a relative’s funeral—turned into a quest. My starting point was the issue of outpatient dispensing of medication, at least occasionally, like for a vacation once a year or a business trip. My husband used to work in Austria, where we registered with a licensed doctor and could get the medication. But getting there was nearly impossible: flying was too expensive, and other routes took too long.
I started fighting for this, not even knowing it was called an advocacy campaign. I got the support of three more people—another family and one program participant. There were five of us activists who organized the campaign. It wasn’t fast, but eventually, it became one of those that pushed our legislation to change and allow outpatient dispensing. My husband and I received the first take-home medication after nine and a half years of daily visits to the clinic. That’s why it’s sometimes funny when people now complain that waiting three to six months for take-home medication (according to Order 200) is too long.
That was my personal achievement. And from that moment, people in the program saw I had knowledge and started reaching out to me. Back then, I thought of it as just conversations, but now I understand I was consulting them as a paralegal. Social workers from the NGO Light of Hope noticed this too. Once, Oleg Dymaretsky (director of “VOLNa” – VirusOFF note) approached me and said, “Why are you wasting your time?”
Of course, they didn’t hire me right away. I volunteered for two and a half to three years. At that time, I was in a personal crisis, on the verge of depression. I remember my husband saying, “Please, keep doing this. For the first time in two years, I see the spark in your eyes again.” He fully took over providing for our family so I could volunteer. That’s how it all began.
— How did the war affect the needs of the community?
— Basic needs came first. People lost jobs, housing, and even temporary side work. Many lost everything they had. Covering basic survival needs became the priority. Let’s be frank: many people were used to solving these problems through crime—stealing something, selling it, and buying what they needed. But with the start of the war, legislation changed: even petty theft is now prosecuted more severely and can result in real prison time. Before, stealing a piece of sausage might mean probation, but now—it’s jail. So those who can still think ahead started realizing: it’s not worth it. But the needs haven’t gone away—just the priorities shifted.
— Now you’re a regional coordinator at “VOLNa.” Tell us more about this work.
— Yes, I am the regional development coordinator in the Poltava region. At the same time, I’m also the director of the NGO Eastern Resource Center of the All-Ukrainian Association of People with Drug Dependence “Meridian” (that’s the organization’s official name in the documents). It’s legally based in Poltava, but its activities cover Poltava, Sumy, Kharkiv, Cherkasy, Chernihiv, Kyiv (instead of Donetsk), and Kryvyi Rih. We are part of “VOLNa,” but separate: we have our own strategy and operational planning, and we seek funding independently based on regional needs. Since 2019, a community center has been operating at our Poltava base, so there are always a lot of people.
— How did you get involved in the VirusOFF emergency aid project?
— I already knew Oksana Dobroskok (Coordinator of the emergency aid project, funded by ViiV Healthcare Positive Action – VirusOFF note) from the time we both participated in the steering committee of the National Platform of Key Communities. She called Oleg Dymaretsky and asked, “Who on your team could join the project?” Oleg recommended me. That’s how I joined.
— What are the main barriers to accessing social and medical assistance for the community today?
— They existed before the war and remain the same now. The main ones are stigma and discrimination. Even when I tell doctors I represent the community and ask them to take that into account when treating me, I often hear: “Well, what did you expect after using drugs for 20 years?” No matter what problem I come with.
At the end of 2023, I was in bad shape. I barely made it to an endocrinologist. It turned out the cause of my trophic ulcers was endocrine, but for 15 years, vascular surgeons had been treating me. Nobody wanted to dig deeper: the “drug addict” label was enough. So I believe stigma is the main reason why people don’t receive adequate services.
We’re trying to change this. We conduct training for family doctors and specialists. But go 30 km outside Poltava—and there, they know nothing. Some doctors still say that key populations vulnerable to HIV are “people with higher income.” Some still believe HIV is transmitted through household contact. In medical schools, this topic is taught only as an elective. It’s not even allocated an hour in the curriculum.
— Is there any support from local authorities or state institutions?
— In our region, some things are done, but a lot depends on personal connections. Once, after a meeting of the regional coordination council on TB, HIV, and drug dependence, the deputy head doctor of a regional clinic called me and said, “Yanina, please come in, let’s talk. Enough of criticizing us.” They realized I wouldn’t stay silent. Later, they started inviting me to working groups.
There was also a negative experience: my ideas were used by other organizations and presented as their own. It was hurtful. But my husband comforted me: “The main thing is that the community benefited.” Now I know I must protect my ideas.
— What kind of assistance was provided in Poltava and the region within the VirusOFF emergency aid project?
— All types of humanitarian aid were in demand, and we had no right to leave people alone with their troubles. Temporary housing or relocation was a unique service. Very important was assistance with restoring documents: without a passport, a person cannot receive even the bare minimum. And for someone who uses psychoactive substances, this can become a point of no return. 600 hryvnias for document replacement is literally the price of life, because a homeless person can never save that money. Also — basic needs: medicine, food. During the winter phase, kits with blankets and power banks were very helpful.
— Are there stories of assistance that especially stuck with you?
— There are many. One example is about people taken from Kherson prisons to Russia. During the occupation of Kherson, about 2,500 people were deported from local prisons, most of them Ukrainian citizens with infectious diseases such as HIV and tuberculosis. For example, from the Holoprystan prison, where TB patients were treated, people were sent to Russia.
After serving their sentences, they were released and given papers saying they had just been freed from Holoprystan Penal Colony No. 7. But in Russia, migration authorities immediately detained them, saying they were there illegally, and placed them in temporary detention centers for foreigners. People could stay there indefinitely, since a Russian court had ordered their deportation, but with no diplomatic ties, that was impossible.
Our organization, in partnership with the international human rights network UnMode, initiated a project to free these people. Many had no access to vital treatment, including ART or TB therapy, and some had already been in these centers for 10 months when we intervened. We organized their evacuation through a third country—since Lithuania didn’t work out, we chose Georgia. It was complicated and expensive: after arriving in Georgia, people had to wait for Ukraine’s consulate to issue a “white passport,” valid only for one trip home. During this time, we had to provide them with housing and food, sometimes for 3–7 weeks.
Funding came from the UN Fund. Within the project, we managed to transport people from Georgia to Moldova. From there, they traveled to Ukraine. But after crossing into Georgia, the project didn’t cover their needs — like transport from Chisinau airport to their homes in Ukraine. This is where the VirusOFF project became crucial. It covered housing and support during the Security Service of Ukraine (SBU) checks at the border, ensuring they hadn’t been recruited, and the transport costs from Chisinau to their places of residence.
Some had been registered and had housing in temporarily occupied territories. In theory, some still had homes, but in practice, they couldn’t return. Others had homes destroyed by war. We placed such people in shelters in Lviv and Ivano-Frankivsk, and in the Poltava adaptation center for former prisoners. We supported everyone possible—those who wanted and could, took the opportunity.
Our activity continued until 2024, after which another organization took over. The main goal of the project was to demonstrate the mechanism and practice of helping such people. Thanks to our efforts, 43 people returned to Ukraine, and in total, 112 received assistance. Some decided to stay in Georgia and legalize there. In any case, it became a chance for a new life.
This material was prepared as part of the VirusOFF emergency aid project funded by ViiV Healthcare Positive Action. The project has been active since March 2022 and provides emergency humanitarian and social support through the VirusOFF platform to members of key populations affected by HIV, as well as to local organizations. To date, over 1,500 individuals from these communities have received assistance through the project.