Part 2: Is there a way out? (Part 1: here)
In the 'outside' world
It so happened that my father died when I was in prison. My mother asked me to take my name off the residence register, because she wanted to move by exchanging flats. I did, but when I was set free, my mother refused to re-register me. She told me that they had had enough of my drugs, stealing, and now HIV; my sister was growing up and she should be protected.
To make things worse, the local TV station ran footage of me every day for a month. They filmed me sitting at a bus stop gouching out [relaxed and content], and I was so out of it that I didn't notice I was being filmed. The line scrolling along the bottom read 'Don't do drugs!' At the time I didn't know that I could actually sue the TV company for invasion of privacy. Of course, my mum saw it, our neighbours and friends of our relations. After that they wouldn't have me in their houses. Every week mum would bring 200 roubles and some food to me in the park near our house, as if I were a total beggar.
I had to steal regularly to pay for my fixes and food. I stole everything - phones, purses, gold from drunken men. My dose was huge, nearly 2g a day; I would inject half a gram at a time. I was stealing day in day out and sometimes didn't get any sleep for weeks. I would doze off for a couple of hours on a stair somewhere, then I was back to looking for money. The rattle was terrible and I had to inject Dimedrol, Phenazepam and Reladorm because heroin alone was no longer sufficient.. I won’t lie that I stole millions each day: sometimes it was three thousand dollars, sometimes a thousand roubles, which was hardly enough to keep me from dying. When I had a lot of heroin in my pocket, I would go to friends to spend the night for a dose; when I only had enough for myself, then it was the stairwell of an apartment block.
In February 2005 I got pleurisy because I was sleeping rough: my immunity was already low and HIV-positives are predisposed to pulmonary diseases. I felt terrible. I was struggling to breathe, hardly able to walk and existing on just heroin, but in that state I could no longer steal. I had to go to the HIV department of the hospital for infectious diseases. I was there for a day, then I ran away. The rattle was so bad that I didn't care about any treatment. True, the heroin rattle is nothing like as bad as the opium rattle; it's more about psychological dependence.
The rattle begins with fever and shivering; you go hot and cold, you're covered with cold sweat. Vomiting, diarrhoea, you keep dashing to the toilet, only you do not know what to do first – either throw up or throw yourself on the john. Your whole body is twisted up and you tie yourself in knots trying to find the least painful position. Insomnia can go on for months. All the time you have just one thought in your head – where can I get some money? In this condition, people are capable of doing anything. I did some very rash things: you can't control yourself and you become a zombie, a slave of the rattle – who cares about treatment for pleurisy! There is no drug treatment in any of our hospitals. You only have the inpatient department of the drugs clinic. It's obviously regarded as a personal choice: either you treat the pleurisy or you shoot up, and nobody cares about the rattle.
This is related, I think, to our society's stereotypical way of thinking about drug addicts. They are scum and there is no need to spend taxpayers' money on them, so the sooner they die the better. Doctors obviously think it's our choice: normal people wouldn't do drugs, they'd get treated. I am a drug addict, so what difference does it make, whether I die of pleurisy or overdose in the gutter? Even the HIV department at our local hospital for infectious diseases is just awful: the plaster is likely to fall on your head, the linoleum's all curled up, so if you can't walk properly and don't lift your feet, you could crack your head open. Prison camp conditions are much better. In the hospital it's perfectly clear that no one cares how drug addicts with HIV die.
So I stayed one day, stole a mobile phone and left. The rattle was terrible and I couldn't think. My pleurisy never did get treated, I just kept going on heroin. Six months later, when I went to prison, I started feeling awful. Weak, sweating, breathless and unable to walk. Later I realised that this was the beginning of tuberculosis. The condition worsened in the autumn and the spring and went on like this for a year. When I went to the medical unit for help, they would mock me: movement is life! Once during morning gymnastics I fainted and they took me to the infirmary. I stayed there in bed till lunch, then they sent me off back to the squad. X-rays showed shadows: the doctors said it was a relapse of the pleurisy and injected me with antibiotics for pneumonia. This only makes the tuberculosis worse, as the two diseases belong to different groups. I was treated for pneumonia twice in one year, while all the time the TB was rapidly getting worse.
In the autumn of 2006 I heard our Minister of Health speaking on the radio. She said that our AIDS-centre now had antiretroviral (ARV) drugs for 210 patients, but so far only 70 had shown up for treatment. At that time, they did CD4 tests once every six months, but no HIV viral load tests at all. When my immune system dropped to 140 units, I started sounding the alarm - give me this treatment! I quoted the minister’s speech and talked about my civil rights: in this case, the right to health and to medical care. Their answer was that I should have thought of that when I was 'outside'. You can get treatment when you get out. And stop shooting up.
I wrote to the Minister of Health and described the situation and mentioned her radio broadcast. Of course, my letter didn't go anywhere. I sent a second one through a staff member - it went off, but there was no answer to it for a long time, and I was getting worse and worse. I cut my veins, and got 15 days in the punishment cell for self-harm. I demanded that they call in the official responsible for due process of law in the prisons. They didn't do this. My temperature was up to 40° and I spent whole days doubled up on the cement floor shaking. The screws would come in and kick me – get up, the rules prohibit lying down in the punishment cell during the day! Even the medical worker didn't come to treat my veins, though with HIV my arm could get inflamed in insanitary conditions. They didn't take my temperature, though I asked them for help. The law states that with a temperature of over 37° I should have been taken to the infirmary, but nothing of the sort happened! I had to go on hunger strike, with slit veins, high fever and low immunity. I stayed on hunger-strike for ten days until they called in the inspector. They could force feed me through a tube in the event of a life-threatening condition, but they expected me to crack: if I started to eat, that would mean I acknowledged I was wrong.
It was only when the inspector arrived and I was transferred to the infirmary that things started to happen. A specialist in infections came from the regional AIDS centre and prescribed treatment for me and six other girls. But the treatment couldn't do much for me by then because I had left behind my remaining health in the prison cell. My neck was swollen, my lymph glands enlarged, I could hardly walk, I didn't eat or sleep and I realised I was dying. A team of doctors from the Department of the Federal Prison Service was called in for consultation. They looked at my neck and at the X-rays and said in my presence, ‘Well, she's a goner!! 2 months at the most, lung collapse!’ After that I was promptly taken away to a TB ‘zone’. I was in a terrible state, but the administration knew I could stand up for my rights and sent me to the prison hospital with the documents for release on medical grounds.
The doctor came to see me the day after I arrived there. I couldn't get up and the girls had to carry me to the toilet. He asked me to behave, keep quiet and not put the girls up to anything – I'd be free in a week. There were no tests or X-rays: I was released 19 months early to protect the backs of the administration who had allowed me to deteriorate so badly by not examining me properly or detecting the TB when my lungs started to decay. They had failed to prescribe ARV in time or provide medical care in the punishment cell. So they had not only infringed my rights, but damaged my health and put my life seriously at risk.
At the prison hospital they started giving me TB drugs in addition to the ARV medication: they treated me all right, probably because I had come with a ‘good’ reputation and nobody wanted to mess with me for the 2 weeks. They were already prescribing ARV at the prison hospital, but for some reason the girls refused to take it. They threw it down the drain with their TB pills. They'd heard a lot of rubbish about them shortening your life and tried to convince me not to take them either. No one could give me chapter and verse and no information sessions had been organised by the authorities, but everyone knew, or had heard of, someone who had died from it.
Getting drugs into a ‘zone’ was no problem either. In male prison camps, the staff themselves would bring in drugs for money; it was a bit more difficult in female camps, because the screws are afraid of having anything to do with women. One might brag that she'd had a fix that day and another one would turn her in out of jealousy that she hadn't had her share. But anyway, husbands or relatives sneak it in when visiting. Half of the prisoners were gypsies, doing time for selling heroin and all acquaintances came from the gypsy camp: you made a deal with them, and they'd get it brought in. If you wanted to, you could get hooked into the 'system'. I preferred to share with people when they got some from their visitors. I tried not to do this too often, but it's no problem if you set your mind to it, particularly if there is someone from 'outside' who can bring you heroin in large quantities.
In male prison camps it gets thrown over the security fence: people drive up close, having made a phone call, throw it over and that’s it. It's actually no more difficult than in the outside world, but delivery takes a bit longer. Needles were more difficult. They could be sneaked in from the visitors' room in the vagina like a tampax, or a member of staff would bring in a couple for money. These are cherished and hidden in a safe place. Of course, a needle would then be shared by a crowd of people, no one has her own. People are glad if they are offered a fix, and it makes no difference whose needle it is and what disease they might have. Normally five or six prisoners inject from one delivery, but they may then share their syringe with another group who have got heroin too. Beggars can't be choosers there.
A new life
So I went from the ‘zone’ to the TB clinic. My mother didn't want to come and take me home even though I was dying. It was April 2007, springtime, blossom everywhere. I was so sorry to be dying. I don't know what the miracle was, but in a couple of weeks I started getting better. A month later I got taken on as yard keeper for the hospital because nobody was helping me and I had to have something to live on. I would get up at five in the morning, take ARV, sweep out the yard and remove the garbage. Then I would come back by 9am to have breakfast, take the TB pills and go back again to trim some bushes; I took pleasure in working. When you've had one foot in the grave, you come to re-appreciate life ….
Then I was promoted from yard keeper to orderly. I worked 2 years in this job. I had already recovered and managed to get social housing, but I kept working. I had got used to the patients and the clinicians who had put me back on my feet. Medical orderly work is hard. We carried out corpses every day as the death rate was very high. Ten bed patients in the ward, all needing to be washed and have their diapers changed. At first I worked at the female ward, but after Taya Suslova’s death I became an HIV-activist. I was trained as 'peer counsellor', and moved to work as a medical orderly on the ward for HIV-positives with active TB. I advised them on adherence to ARV and did follow-up work – I was working on two projects for the AIDS centre.
But two years later I was back on the heroin. It was hard burying a friend every week. In fact, I had allowed myself some gear from time to time as I was earning quite a bit and I don't like alcohol. I had occasionally to bring gear to terminal patients and inject with them. But I wouldn't go back on the ‘system’ and controlled myself; I didn't want to go back to prison, but now I was really badly hooked. I left the job, the projects and lost everything I'd earned by my back-breaking work. I started visiting the prostitutes: I’d been in prison with some of them and others had been clients in my projects. They would give me a treat and help me buy heroin when I received my disability pension; this went on for 3 months.
I don't know how it would have ended up, prison or death, if I hadn't been kicked out on the street. In the hostel where I live, the rules are very strict: you can't stay there if you're drunk or high and you're expelled if you don't work. I spent 3 days on the streets. It was September 2009. I remembered my previous life, which I'd managed to get free of, and understood I'd reached the end: I had no housing, no means of subsistence. I didn't want to go back to prison: I was already not so young and my relations with the adminstration were terrible, because I'd made so many problems for them by insisting on my rights – they'd do me in at once.
By some miracle I found I had the power in me to stop. I went to the TB clinic and got through the rattle on alcohol and sleeping pills. I didn't go to the drugs clinic, because I had already been signed off and my records had been archived. If I'd gone there, they'd have registered me as active. I couldn't afford private, anonymous treatment. My criminal record means that finding a decent job is hard, because the security services check their database and if they saw my name on the register, then I'd be blacklisted for ever.
The here and now
Three months later I went back to the hostel. I was given accommodation again, because the administration of the hostel turned out to be remarkably humane. Now I am trying to control my drug use and not inject frequently for several days on end to avoid the rattle, but I always want to inject. When I don't inject for a long time, I am tormented by depression, mood swings and I crack up. I try to use alcohol to deal with these problems, but that only makes them worse. When I drink I get aggressive because my brain is subconsciously expecting something absolutely different, opioid euphoria. So when I've had a drink, I always try to have an injection to get rid of that ‘alien’ condition and quickly get back to the usual, heroin one.
If drugs were legal and one didn't have to take to crime to find the money for a fix and if I had the choice to use or not to, I would go on doing drugs till the end of my life, because it's only in this condition that I feel fully engaged and comfortable.
Recently Irina Teplinskaya applied to the UN to help her in her attempts to force Russia to provide opioid substitution theory for drug addicts. She was helped with her appeal by the Andrei Rylkov Foundation for Health and Social Justice, Moscow www.rylkov-fond.ru
Part 1 can be read here