Interview: Igor Veljkovic, president of the civic association H.E.R.A

The official data on HIV/AIDS do not depict the real situation in Macedonia

The so far work of the civic associations has been too focused on the capital city, and the existing services offer help to a relatively small number of people. The end of last year, more precisely the first half of December was in a spirit of fight against HIV/AIDS. The civic association H.E.R.A, with its activities, is becoming a more visible segment in the civic fight for actualizing the problems related to the disease of the past, but, unfortunately, it seems, of this century, too.

In this occasion, we talked to Igor Veljkovic, the actual president, one of the founders of H.E.R.A, a graduating student at the Faculty of Medicine in Skopje, who has been involved in the civic sector since 1998. So far he has worked as a volunteer in the civic associations HOPS – Options for healthy life in the realization of the national and regional campaign for fight against HIV/AIDS.
 

C.W. – What does H.E.R.A stand for?
I.V. – H.E.R.A stands for Health Education and Research Association and it is a civic association whose basic mission is to promote habits for healthy life among young people, with special accent towards advancing their sexual and reproductive health. Within the above mentioned, the association realizes educational classes on sexual education in high schools in the Republic of Macedonia, promotional activities related to prevention of HIV/AIDS and sexually transmitted infections, as well as counseling, health education and support to people infected with HIV/AIDS.
This civic association was formed in 1999 and about fifty young people of different professional orientation take active part in it.


C.W. – The problem with HIV/AIDS is a global, planetary problem. What are the specifics of the civic approach in its solving, in the region where Macedonia is situated?
I.V. – The official data on the HIV/AIDS problem in the Republic of Macedonia do not depict the real situation of this problem in the country at all. Above all it results from the inefficient system of following the HIV-infection, especially regarding the socially marginalized groups, as well as the weakly developed network of health and social services on this issue, both in the public and civic sector. On the other hand, it is more than obvious that the Republic of Macedonia has been facing social and economic conditions that only “facilitate” spreading HIV-infection in the country for years. The rapidly increased number of new intravenous drug users, the increasing trend of spreading sexually transmitted infections, the growth of illegal prostitution and women trafficking, the presence of internally and externally displaced people, as well as foreign military forces, only “fill up” the mosaic of risk factors. According to the data from the World Health Organization, HIV/AIDS epidemic is possible in the region of South-East and Eastern Europe in the forthcoming years to great extent, where, unfortunately, over the past years there has been a trend of rapid spread of HIV infection. Just as an illustration and comparison, Estonia, a country that according to many demographic and social trends is close to Macedonia, until 1999 had almost an identical number of HIV/AIDS cases with our country. Literally overnight Estonia has become a “recorder” of the number of newly registered cases of HIV/AIDS within world frames?! Almost 1.700 new cases within a year, in a country with a population of 1.5 million people.

If I may say in all modesty, over the past years, only the civic sector in the Republic of Macedonia has actively worked on promoting preventive activities regarding the HIV/AIDS problem. In my opinion, it is very important that the civic associations in the country are really focused on their activities, especially regarding the HIV/AIDS prevention within the groups of highest risk: young, intravenous drug users, homosexuals and prostitutes. As an example, the civic associations HOPS – Skopje, Doverba – Skopje, Social Workers Association of the City of Skopje, Izbor – Strumica and H.E.R.A – Skopje, have established counseling services for HIV/AIDS and sexually transmitted infections (SOS lines and citizens’ advice bureau), have developed field work among the target groups, education in high schools, programs on decreasing the damages of intravenous drug use, as well as providing social services and legal assistance. However, my personal impression is that the so far work of the citizens associations has been too focused on the capital city, and the existing services offer help to a relatively small number of people. It results in a need for strengthening the capacities of the existing organizations and decentralization of their activities throughout the country.
 

C.W. – Which age groups do you work with and how do you operate?
I.V. – Our activities are, above all, focused on the young population, through organized activities of sexual education in high schools, with support from the Agency for Youth and Sport. However, I would like to explain that we do not give “classic” lectures in high schools, since the transfer of information and knowledge is carried out by the method of “Education among the young people at the same age“. It means that previously educated and trained young people from our organization become educators among young people at their age, classmates or friends. The way these young people transfer the knowledge depends on their creativity and communication skills they have acquired during their training. In any case, it is about the most acceptable and appropriate way of communication among young people, topics and issues that intrigue their intimacy or still are “taboo” topics in the family.

 
C.W. – What is the cooperation with the educational and health institutions in the country like?
I.V. – In 2000 we started cooperating with the Republic Bureau for Health Protection to promote free and confidential HIV counseling and testing. The initiative resulted from the great number of calls on the H.E.R.A info line related to HIV-testing, so there was a need for affirmation of the existing possibilities of HIV-testing in Macedonia in the public, above all the possibility for free and confidential HIV counseling and testing. This cooperation significantly increased the number of people who take the HIV-test in the Republic of Macedonia on voluntary basis, and according to the data from the Republic Bureau for Health Protection, that number is 800-1000 people per annum. As a member of the National Inter-department HIV/AIDS Commission, the non-governmental association H.E.R.A was involved in the preparation of the HIV/AIDS National Strategy, officially promoted on 1 December last year. From an aspect of the civic sector, the most significant is its acceptance as one of the most important governmental partners regarding HIV/AIDS issue, and even more important, all the so far and existing program activities of the civic sector in Macedonia have been involved and acknowledged in it. In that sense, I would like to point out the fact that a lot of countries in the world have built a strongly restrictive policy towards a part of the civic sector’s activities. Above all towards the programs for HIV/AIDS prevention that refer to decreasing dangerous consequences of intravenous drug use, as in Russia, for example.

As far as the financial support of the programs projected with the National strategy is concerned, last year the Republic of Macedonia successfully applied to the HIV/AIDS, Tuberculosis and Malaria Global Fund. It is an executive and coordination body of the most developed countries in the world, established by initiative of the United Nations organization and over the past two years it has approved over 2 billion dollars, assets aimed at preventing HIV/AIDS epidemic within world frames. The project-proposal of our country is with a time frame of two years and it has been approved in total amount of $4.3 million, with a possibility for one-year extension in total amount of $6.3 million. Apart from the civic associations and representatives of the Ministries of Health, Education, Defense and Finance, in the preparation of the project-proposal to the HIV/AIDS Global Fund, the support of the American Agency for Development (USAID) and the Institute for Sustainable Communities from Skopje, that have given expert and financial support to this process, have been of significant importance. The realization of the activities projected with this project is expected to start towards the end of this year.

 
C.W. – Which direction should the preventive activities in Macedonia take and what are the necessary instruments for faster and more efficient results?
I.V. – I might be repeating myself in the answer of your second question, but personally, I think that the existing activities of the civic associations should be more intensive, with equally improving their professional capacities and opportunities for work, as well as with decentralization of their activities. A direct approach in the work with the target groups should be promoted, especially with the socially most endangered groups, as well as their direct involvement in creating and realizing the programs regarding them. I would also like to mention the periodical campaigns for raising the public awareness regarding HIV/AIDS problem, but still, in context of promoting direct approach of work, I think that the biggest priority should be opening new and strengthening the existing health-social centers that offer counseling and education for HIV/AIDS prevention, as well as care of the people who live with this problem. At the same time, it is necessary to “recruit” many new people who will be involved in these preventive activities.

 
C.W. – What are the so far experiences in the regional solving the HIV/AIDS problem?
I.V. – Because of the similar aspect of the HIV/AIDS problem in the region, the need to share experiences with organizations from South-Eastern Europe is necessary. As a result of that, last year, together with our partner organizations from Serbia and Montenegro (Yugoslavian Association for Fight against AIDS) and Bosnia and Herzegovina (Association for Fight against AIDS), we realized the Regional campaign against discrimination of the people who live with HIV/AIDS, under the motto “Involve everyone”. The campaign had a common visual identity in all three countries that was later accepted both in Romania and Kosovo.

Most of the organizations we cooperate with in the region have almost identical working approach, so very often there are regional seminars for exchange of experiences among the organizations, and with some of them we also have a program developed for volunteers exchange. 

The SOS line for information and prevention of HIV/AIDS and sexually transmitted infections is a project that started operating in April 2000. The most frequently asked questions are the way of transmitting and protection from infections, correct use of condoms, symptoms of HIV-infection and other sexually transmitted infections, as well as advice related to HIV-testing.

The phone line is 02/3128-067 and it operates every day from 13 to 21, with over 4.500 calls in the so far period of work.