Raised in the industrial city of Magnitogorsk, Tanya’s* life was deeply affected by her parents’ alcoholism. Having spent much of her youth in the streets, by the time Tanya was 21, she was diagnosed as HIV positive from intravenous drug use. Her mother was living on the street, her father was in prison, and her older sister was a drug addict and prostitute with nowhere to turn for support. Carrying the burden of what she assumed to be a death sentence, Tanya continued her dangerous lifestyle even after becoming pregnant in 2005 and was unable to receive prenatal care at the hospital, because she had lost all her documents (required to receive state health benefits in Russia). Although she kept her child, Tanya didn’t give up drugs and lacked maternal instincts, casting a dark shadow on the fate of her baby daughter.
Sadly, Tanya’s story is not unique for Magnitogorsk. In 2005, 188 children in the city were born to mothers infected with HIV, and in 50% of the cases the mothers first learned of their HIV-positive status during their pregnancies and deliveries. Given the absence of any comprehensive social and psychological support system for HIV-positive mothers in the city, many women become overwhelmed by feelings of hopelessness and opt to give up their children to the care of state institutions. In 2004 alone, 16.2% of HIV-positive mothers abandoned their children in the city, as compared to 2.8% of HIV-negative women. In response to the lack of a place for these women to turn for help, two organizations joined forces in November 2005 to develop a system for child abandonment prevention among HIV-positive mothers in Magnitogorsk.
In coordination with the IREX-administered, USAID-funded Assistance to Russian Orphans (ARO) [7] Program, the “Center for the Prevention of and Battle with AIDS” and the NGO “Civil Initiative” organized the ROSA Center of Alternative Services, which provides complex social and psychological support to HIV-positive women and their families. This was possible in part as a result of an IREX interregional conference that included a project seminar for potential ARO grant recipients on project development. Consultants taught the participants how to determine their project objectives, tasks, and results. IREX then conducted a seminar for grant recipients on grant management and reporting. Additionally through ARO, IREX provided consulting on fundraising, government relations, and organizational development; as well as a psychologist who visited the organization to evaluate the project and offer advice for improvement. The ROSA Center now utilizes an effective, multidisciplinary team approach involving case managers, social workers, psychologists, and peer counselors. Together these teams develop individual plans to meet the particular needs of each woman in crisis.
The aim of the psychological counseling services offered by the ROSA Center is to strengthen the bond between the mother and child and to interact with relatives to ensure a positive home environment in which the child can be raised. The ROSA Center and the Magnitogorsk City Healthcare Department also developed a peer counseling system at maternity wards and consultation centers. The peer counselors are HIV-positive women who have personally overcome many of the same challenges these women currently face. They are able to answer HIV-positive mothers’ questions about the virus and how to care for their children based on personal experience.
When an infectious-disease doctor put Tanya in touch with a case manager from the ROSA Center, she was initially skeptical. But Tanya was ultimately drawn in by the case manager’s promise to help guide her through the bureaucratic maze involved in replacing her lost documents, and shortly thereafter a social worker from the center began visiting Tanya at her grandmother’s home. Tanya later began meeting a peer counselor and psychologist, and after two months she decided to attend the weekly “Happy Motherhood” support group organized by the ROSA Center. Over time, Tanya’s maternal instincts slowly awakened, and she became as protective and invested in her child’s wellbeing as the others.
Tanya not only found a positive example in the experts and mothers at the ROSA Center, but also new friends she could rely upon for help in everyday life. With their support, Tanya now adheres to her HIV treatment regimen and plans to return to school to find a profession, as providing her daughter with the happy home life she lost has become a priority. The hopelessness that once haunted her is a thing of the past, and Tanya was overjoyed to hear that the results of her daughter’s HIV exam came back negative.
Tanya is just one example of the ROSA Center’s success. In the first nine months of its work, 70 HIV-positive women took advantage of the innovative services offered there, and not one of them abandoned her child. The interdisciplinary system of social and psychological support for HIV-positive mothers developed by the center was so successful that Drobyshev City Hospital #1 integrated the ROSA Center into the social department of the Magnitogorsk AIDS Center. Similarly, IREX decided in 2007 to support a project by Civil Initiative to implement a citywide system of child abandonment prevention among HIV-positive mothers in Magnitogorsk based on the successful experience of the ROSA Center, bringing the services that saved Tanya and her daughter to an even greater number of women and children in need.
* All names have been changed to ensure the privacy and confidentiality of those involved.
